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Left atrial appendage function study by transesophageal echocardiography<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
吴长君 肖竹影 傅世英 刘凤岐 赵进军
单位：150001哈尔滨医科大学第一临床医学院
中华心血管病杂志 1999年第3期第27卷 第五次全国心血管病学术会议专栏
WU Changjun, XIAO Zhuying, FU Shiying,et al.
First Clinical College of Harbin Medical University, Haerbin 150001
Abstract
Objective：To evaluate the predictive value of left atrial appendage (LAA) function in success of electrial cardioversion (ECV) in patients with nonvalvular atrial fibrillation (NVAF), and observe the course of the recovery of LAA systaltic function.
Methods：To test blood flow wave patterns, peak emptying velocity (PEV) of LAA and left atrial spontaneous echo contrast (SEC) of left atrial appendage before ECV and after ECV 24 hours, 3 days and 1 week in 60 patients with NVAF by using transesophageal echocardiography (TEE).
Results：(1) Patients with LAA-PEV≥20 cm/s had a ECV success rate of 75%, in contrast, LAA-PEV＜20 cm/s had that of 30%. (2) LAA blood flow wave patterns converted to a organized contraction patterns. LAA-PEV (23±10 cm/s) was lower than that (30±10 cm/s) before ECV (P＜0.001); SEC could be generated in 8 patients, intensified in 11 patients.
Conclusion：LAA mechanical activity prior to ECV is highly related to maintenance of sinus rhythm in NVAF, and LAA “stunning” developed a thrombogenic milieu. Patients with atrial fibrillation should be given full anticoagulation to prevent thrombogenesis in left atrial and LAA.
Key words：atrial fibrillation electric countershock echocardiography, transesophageal
心房颤动（房颤）是临床上最常见的心律失常，电转复房颤为窦性心律可使患者获益。我们利用经食管超声心动图(transesophageal echocardiography, TEE)检测左心耳功能，为房颤患者电转复治疗的选择和复律后抗凝疗程的判定提供新的依据。
资料与方法
1． 研究对象：非瓣膜病房颤（NVAF）患者60例，男42例，女18例；年龄37～75（平均59）岁，其中高血压性心脏病24例，冠心病18例，扩张型心 肌病6例，心包炎3例，孤立性房颤9例。房颤持续时间为2周至6个月。经临床及超声心动图证实无二尖瓣狭窄及二尖瓣置换术病史。合并二尖瓣反流者，反流量在中度以下。 | 
