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目的利用64层螺旋CT血管成像技术研究心力衰竭时肺静脉形态与心房颤动的关系。方法75例入选病例按是否存在心衰和房颤分为心衰组、心衰合并房颤组和对照组,其中心衰组35例,心衰合并房颤组19例,对照组21例。利用64层螺旋CT对3组患者进行肺静脉造影和左房形态学检查,并利用三维重建技术对四个肺静脉开口直径,包括上下径和前后径,以及左房直径,包括左右径、前后径和上下径进行测量,比较3组间上述测量数据的差异。结果心衰组、心衰合并房颤组与对照组相比,四支肺静脉开口直径和左房腔径均有显著增加;心衰合并房颤组与心衰组比较,四支肺静脉开口直径和左房腔径也有显著增加;心衰组不同NYHA心功能分级患者的肺静脉开口直径和左房腔径随心功能级别增加而显著增加。结论心衰患者四支肺静脉均呈显著扩张,肺静脉这种形态异常可能是心衰时房颤发生和维持的结构基础。
Objective To study the relationship between pulmonary vein morphology and atrial fibrillation in patients with heart failure by using 64-slice spiral CT angiography. Methods Seventy-five cases were divided into heart failure group, atrial fibrillation group and control group according to the presence or absence of heart failure and atrial fibrillation. Among them, 35 cases were heart failure, 19 cases were heart failure complicated by atrial fibrillation and 21 cases were control. Three groups of patients underwent pulmonary vein angiography and left atrium morphometry with 64-slice spiral CT. The diameters of the four pulmonary veins, including the upper and lower diameter and anteroposterior diameter, and left atrial diameter, including left and right diameter, anteroposterior diameter and Upper and lower diameter measurements were made to compare the difference between the three groups of the above measured data. Results Compared with the control group, the diameters of the four pulmonary veins and left atrium were significantly increased in the heart failure group, the heart failure complicated with atrial fibrillation group and the control group. Compared with the heart failure group, the diameters of the four pulmonary veins and The diameter of the left atrium was also significantly increased. The diameter of the pulmonary veins and the size of the left atrium were significantly increased in patients with NYHA functional class in the heart failure group as the cardiac function increased. Conclusions The four pulmonary veins in patients with heart failure showed significant dilatation. The abnormal morphology of pulmonary veins may be the structural basis of occurrence and maintenance of atrial fibrillation during heart failure.