Analysis of the Left Atrial Appendage by Three-Dimensional Transesophageal Echocardiography
Analysis of the Left Atrial Appendage by Three-Dimensional Transesophageal Echocardiography
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DOI：
10.1016/j.amjcard.2010.05.014
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发表时间：
2010-09-15
影响因子：
2.8
通讯作者：
Aonuma, Kazutaka
中科院分区：
文献类型：
--
作者：
Nakajima, Hideki;Seo, Yoshihiro;Aonuma, Kazutaka
本研究旨在确定三维（3D）经食管超声心动图（TEE）评估左心耳（LAA）几何形状和大小的能力和可靠性。与二维TEE相比，三维TEE可以更准确地评估左心耳形态，并提供有关左心耳形态的额外信息。使用10个分离的猪左心耳标本对3D TEE获得的左心耳形态学数据进行了确认研究。在107例入组患者中，55例患者为窦性心律（正常窦性心律），其中3D经食管超声心动图图像是通过全容积模式成像获得的，52例房颤患者使用缩放模式成像。在重建的成像上评估了左心耳口面积、深度和体积以及左心耳叶的数量。使用二维超声心动图成像计算左心房容积。在实验研究中，在所有参数中观察到全容积或变焦模式成像测量值与参考数据之间的良好相关性（r > 0.90，p < 0.001）。平均左心耳开口长直径为29.7 +/- 7.4 mm，平均短直径为20.6 +/- 5.9 mm，平均开口面积为5.1 +/- 2.5 cm（2），平均左心耳深度为38.5 +/- 8.2 mm，平均体积为9.2 +/- 5.6零。最常见的左心耳肺叶数量为2个（n = 52），其次为3个（n = 28）、1个（n = 18）和4个（n = 3）。左房容积与左心耳开口长径（r = 0.33，p = 0.001）、短径（r = 0.40，p < 0.001）、面积（r = 0.39，p < 0.001）呈弱相关。左心耳深度（r = 0.21，p = 0.03）和容积（r = 0.36，p = 0.001）。总之，3D TEE是评价LAA几何结构的可靠模式，并提供了量化各种LAA特征的详细信息。(C)2010年爱思唯尔公司All rights reserved. (Am J Cardiol 2010;106：885-892）
This study was designed to determine the ability and reliability of 3-dimensional (3D) transesophageal echocardiography (TEE) to assess the geometry and size of the left atrial appendage (LAA). Three-dimensional TEE may allow more accurate assessment of, and provide additional information on, LAA morphology compared to 2-dimensional TEE. Validation studies for LAA morphology data derived from 3D TEE were performed using 10 isolated porcine LAA specimens. Of 107 enrolled patients, 55 patients were in sinus rhythm (normal sinus rhythm), in whom 3D transesophageal echocardiographic images were obtained from full-volume mode imaging, and in 52 patients with atrial fibrillation, zoom-mode imaging was used. LAA orifice area, depth, and volume and the number of LAA lobes were assessed on reconstructed 31) imaging. Left atrial volume was calculated using 2-dimensional echocardiographic imaging. In experimental studies, excellent correlations (r > 0.90, p < 0.001) between the measurements by full-volume or zoom-mode imaging and reference data were observed in all parameters. The mean LAA orifice long diameter was 29.7 +/- 7.4 mm, the mean short diameter was 20.6 +/- 5.9 mm, the mean orifice area was 5.1 +/- 2.5 cm(2), the mean LAA depth was 38.5 +/- 8.2 mm, and the mean volume was 9.2 +/- 5.6 nil. The most frequent number of LAA lobes was 2 (n = 52), followed by 3 (n = 28), 1 (n = 18), and 4 (n = 3). Left atrial volume was weakly correlated with LAA orifice long diameter (r = 0.33, p = 0.001), short diameter (r = 0.40, p < 0.001), area (r = 0.39, p < 0.001). LAA depth (r = 0.21, p = 0.03), and volume (r = 0.36, p = 0.001). In conclusion, 3D TEE is a reliable modality to evaluate LAA geometry and provides detailed information to quantify varied LAA characteristics. (C) 2010 Elsevier Inc. All rights reserved. (Am J Cardiol 2010;106:885-892)