经食道三维超声心动图对房颤患者左心耳几何和功能的表征

L. Soulat-Dufour , T. Simon , S. Lang , S. Ederhy , S. Adavane-Scheuble , M. Chauvet-Droit , E. Capderou , C. Arnaud , P. Issaurat , F. Boccara , A. Cohen
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引用次数: 0

摘要

心房颤动(AF)患者经食管超声心动图(TEE)三维(3D)显示左心耳(LAA)重构的资料很少。本研究的目的是评估AF中LAA的血栓形成环境、LAA速度、自发超声心动图造影剂/血栓、3D LAA几何形状和体积。方法对206例AF住院患者在入院24小时内进行LAA二维(2D)经胸和3D TEE的前瞻性评估。使用Tomtec软件(4D Cardio-View, Generic Volume, Philips)离线分析3D参数(图1)。根据入院时房颤类型将患者分为两组:阵发性房颤(62例)或持续性房颤(144例)。结果持续性房颤患者BMI较高,高血压、糖尿病患病率较高,且有房颤、心衰、肾功能衰竭病史。他们也有较高的CHA2DS2-VASc。持续性房颤患者入院时LVEF较低,左房容积较高,E、E/ E′和肺动脉收缩压较高。持续性房颤患者LAA自发回声造影物/淤积更严重,LAA排空和充盈流速更低,3D LAA测量值(心房面积、长度、体积)更高(表1)。结论LAA的3D评估可能反映房颤的心房重构,似乎与房颤负担有关。需要随访数据来确定这些异常对此类患者风险分层的影响。
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Characterization of left atrial appendage geometry and function using three-dimensional transesophageal echocardiography in patients in atrial fibrillation

Introduction

Few data are available on left atrial appendage (LAA) remodeling using three-dimensional (3D) transoesophageal echocardiography (TEE) in patients in atrial fibrillation (AF). The aim of this study was to evaluate LAA thrombogenic milieu, LAA velocities, spontaneous echocardiographic contrast/thrombus, 3D LAA geometry and volume in AF.

Method

We prospectively evaluated patients 206 hospitalized for AF with two-dimensional (2D) transthoracic and 3D TEE of the LAA within 24 hours of admission. 3D parameters were off-line analysed using Tomtec software (4D Cardio-View, Generic Volume, Philips) (Fig. 1). Patients were divided into two groups according to the type of AF at admission: paroxysmal AF (62 patients) or persistent AF (144 patients).

Results

Patients with persistent AF had higher BMI, more prevalent hypertension and diabetes, as well as history of AF, heart failure, renal failure. They had also higher CHA2DS2-VASc. Patients with persistent AF at admission had lower LVEF, higher left atrial volume, higher E and E/e′ and pulmonary arterial systolic pressure. Patients with persistent AF had more severe LAA spontaneous echo contrast/sludge, lower LAA emptying and filling flow velocity, and higher 3D LAA measurements (ostium area, length, volume) (Table 1).

Conclusion

3D evaluation of the LAA may reflect atrial remodeling in AF and seems to be associated with the burden of AF. Follow-up data are needed to determine the impact of such abnormalities in the risk stratification of such patients.

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来源期刊
Archives of Cardiovascular Diseases Supplements
Archives of Cardiovascular Diseases Supplements CARDIAC & CARDIOVASCULAR SYSTEMS-
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发文量
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期刊介绍: Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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