摘要
目的应用二维斑点追踪超声心动图(two-dimensional speckle tracking echocardiongraphy,2D-STE)技术检测左房心肌应变,进而探讨冠状动脉术后房颤的发生与术前左房功能障碍的相关性,分析CABG术后房颤发生的危险因素,为临床CABG术后房颤的早期预测提供新指标。方法将我院124例行CABG术患者根据术后是否发生房颤分为发生房颤组(POAF)和未发生房颤组(NPOAF),对两组患者的术前左房相关参数及术后心电监测结果进行收集、对比、分析。结果POAF组与NPOAF组在年龄、二尖瓣E峰减速时间、左房容积指数、收缩期左房峰值应变率、左房纵向整体应变、舒张早期左房峰值应变率、舒张晚期左房峰值应变率差异有统计学意义(P<0.05);多因素logistic回归分析显示左房纵向整体应变OR值为0.791,置信区间0.715-0.875(P<0.05),ROC曲线显示左房纵向整体应变曲线下面积为0.898,置信区间0.842-0.953(P<0.05)。结论左房纵向整体应变是冠状动脉术后房颤发生的独立预测因素,可为临床提供有效的影像学依据。
Objective To apply the two-dimensional speckle tracking echocardiongraphy (2D-STE) technology to detecting left atrial myocardial strain,discuss the correlation between occurrence of postoperative atrial fibrillation(AF) of coronary artery bypass grafting (CABG) and preoperative left atrial dysfunction,analyze the risk factors of occurrence of postoperative AF,and provide a new index for early prediction of atrial fibrillation after CABG. Methods According to whether atrial fibrillation occurred or not after operation,124 patients undergoing CABG in our hospital were divided into two groups:atrial fibrillation group (POAF) and non-atrial fibrillation group (NPOAF). Preoperative relevant parameters of left atrium and postoperative electrocardiogram monitoring results of the two groups were collected,compared and analyzed. Results There were significant statistical differences between POAF group and NPOAF group in age,mitral valve E peak deceleration time,left atrial volume index,peak systolic strain rate of left atrium,left atrial longitudinal overall strain,left atrial peak strain rate at early diastolic stage,and left atrial peak strain rate at late diastolic stage ( P <0.05). Multivariate logistic regression analysis showed that the left atrial longitudinal global strain was 0.791,and the confidence interval was 0.715~0.875 ( P <0.05). ROC curve showed that the area under the left atrial longitudinal global strain curve was 0.898,and the confidence interval was 0.842~0.953 ( P <0.05). Conclusion The longitudinal overall strain of the left atrium is an independent predictor of atrial fibrillation after coronary artery bypass grafting,which can provide effective imaging basis for clinical diagnosis.
作者
张淑伟
李玉宏
葛丽丽
Zhang Shuwei;Li Yuhong;Ge Lili(Department of Ultrasound,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)
出处
《锦州医科大学学报》
CAS
2019年第3期66-70,I0006,I0007,共7页
Journal of Jinzhou Medical University
关键词
二维斑点追踪超声心动图技术
左心房功能
房颤
冠状动脉
two-dimensional speckle tracking echocardiongraphy
left atrial function
atrial fibrillation
coronary artery transplant
