2DSTI技术评价老年非瓣膜性房颤病人左心房结构及功能的研究

李娜娜; 任永凤; 王洲; 陆静; 李健; 王效军; 李琦

doi:10.13898/j.cnki.issn.1000-2200.2023.10.020

2DSTI技术评价老年非瓣膜性房颤病人左心房结构及功能的研究

Study on the 2DSTI technique in the evaluation of left atrial structure and function in elderly patients with nonvalvular atrial fibrillation

摘要

摘要:
目的探讨二维斑点追踪成像(two-dimensional speckle tracking, 2DSTI)技术在老年非瓣膜性房颤(non-valvular atrial fibrillation, NVAF)病人左心房结构和功能评价中的应用。
方法选取60例老年NVAF病人(观察组)和60名健康志愿者(对照组)作为研究对象。根据左心房大小分为左心房扩大组与无扩大组。各组均行二维超声及2DSTI检查，获取相关参数包括，左心房最大前后径(LAD)、左心房最大容积(LAVmax)，左心房容积指数(LAVI)、左心房最小容积(LAVmin)，左心房排空分数(LAEF)以及左心室收缩期左心房峰值应变(LASS)、应变率(LASRS)，左心房收缩期左心房峰值应变(LASA)、应变率(LASRA)，对比各组左心房结构及功能检测结果。
结果观察组LAD、LAVmin、LAVI较对照组高，LAEF、LASS、LASRS、LASA、LASRA低于对照组，差异均有统计学意义(P < 0.01)。无扩大组LAEF、LASS、LASRS、LASA、LASRA水平均较对照组降低，扩大组LAEF、LASS、LASRS、LASA水平均低于无扩大组和对照组，差异均有统计学意义(P < 0.05~P < 0.01)，但LASRA水平扩大组和无扩大组差异无统计学意义(P>0.05)。Pearson相关性分析，LASS、LASA均随LAVI增大而降低，呈负相关关系(r=-0.702、-0.741，P < 0.05)。
结论2DSTI检查能够定量检测NVAF病人的左心房功能受损情况，心房无扩大者仍可能检出左心房功能受损，且左心房功能随左心房扩大而降低。

Abstract:
ObjectiveTo investigate the application value of two-dimensional speckle tracking imaging(2DSTI) in the evaluation of left atrial structure and function in elderly patients with nonvalvular atrial fibrillation(NVAF).
MethodsSixty elderly NVAF patients and 60 healthy volunteers were divided into the observation group and control group, respectively.According to the size of left atrium, the observation group was divided into the left atrium enlargement group and nonenlargement group.The observation group and control group were examined using dimensional ultrasound and 2DSTI to obtain relevant parametersincluding left atrial maximum anterior posterior diameter(LAD), left atrial maximum volume(LAVmax), left atrial volume index(LAVI), left atrial minimum volume(LAVmin), left atrial emptying fraction(LAEF), ventricular systolic left atrial strain(LASS), strain rate(LASRS), atrial systolic left atrial strain(LASA) and strain rate((LASRA), and the results of left atrial structure and function were compared between two groups.
ResultsThe LAD, LAVmin and LAVI in observation group were higher than those in control group, and the LAEF, LASS, LASRS, LASA and LASRA in observation group were lower than those in control group(P < 0.01).The levels of LAEF, LASS, LASRS, LASA and LASRA in left atrium nonenlargement group were lower than those in control group, and the levels of LAEF, LASS, LASRS, LASA in left atrium enlargement group were lower than those in left atrium nonenlargement group and control group(P < 0.05 to P < 0.01), but there was no statistical significance in the LASRA level between the left atrium nonenlargement group and enlargement group(P>0.05).The results of Pearson correlation analysis showed that the LASS and LASA decreased with the increasing of LAVI, and which was negatively correlated(r=-0.702, -0.741, P < 0.05).
ConclusionsThe 2DSTI examination can quantitatively detect the impairment of left atrial function in patients with NVAF.The impairment of left atrial function may still be detected in patients without atrial enlargement, and the left atrial function decreases with the enlargement of left atrium.

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