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目的应用实时三维超声心动图(RT-3DE)及二维斑点追踪成像(2D-STI)技术评价射频消融术对心房颤动(房颤)患者左房结构和功能的影响。方法对35例因房颤行射频消融术的患者于术前、术后3d、1个月行超声心动图检查。应用RT-3DE计算左房最大容积指数(LAVImax)、左房最小容积指数(LAVImin)、左房总射血分数(LATEF)、左房扩张指数(LAEI);应用2D-STI计算收缩期、舒张早期左房平均峰值应变(mSs、mSe)、应变率(mSRs、mSRe)及左房僵硬度(LASt)。结果 (1)与术前相比,消融术后3d左房内径和LAVImax增大,mSs、mSe、mSRs、mSRe减低,LASt增高(均P<0.01);(2)与术后3d比较,术后1个月左房内径、LAVImax、LAVImin减小,mSs、mSe、mSRs、mSRe增高,LASt减低(均P<0.01);(3)与术前比较,术后1个月前后径、左右径、LAVImax、LAVImin减小(均P<0.01)。结论房颤患者消融术后3d处于心房顿抑期,左房储存、管道功能恶化,LAVImax增大,LASt增高。术后1个月左房容积减小,左房储存、管道功能有所改善,LASt减低。
Objective To evaluate the effect of radiofrequency catheter ablation on left atrial structure and function in patients with atrial fibrillation (AF) by real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D- STI) Methods 35 patients with atrial fibrillation underwent radiofrequency catheter ablation underwent echocardiography before and 3 days and 1 month after operation. RT-3DE was used to calculate LAVImax, LAVImin, LATEF and LAEI; systolic and diastolic parameters were calculated by 2D-STI Early left atrium mean peak strain (mSs, mSe), strain rate (mSRs, mSRe) and left atrial stiffness (LASt). Results (1) Compared with preoperative, left atrial diameter and LAVImax increased, mSs, mSe, mSRs and mSRe decreased and LASt increased (all P <0.01) 3d after ablation; LAVImax and LAVImin decreased, mSs, mSe, mSRs and mSRe increased, and LASt decreased (all P <0.01) at 1 month after operation. (3) Compared with preoperative, the diameters of left and right , LAVImax and LAVImin decreased (all P <0.01). Conclusions Atrial fibrillation patients with atrial fibrillation 3d after atrial ataxia, left atrial storage, deterioration of the pipeline function, LAVImax increased, LASt increased. One month after surgery, the left atrial volume decreased, the left atrium was stored, the function of the duct was improved, and LASt was decreased.