Association of follow-up change of left atrial appendage blood flow velocity with spontaneous echo contrast in nonrheumatic atrial fibrillation
Association of follow-up change of left atrial appendage blood flow velocity with spontaneous echo contrast in nonrheumatic atrial fibrillation
复制标题
DOI：
10.1378/chest.117.2.309
复制
发表时间：
2000-02-01
期刊：
影响因子：
9.6
通讯作者：
Chen, JH
中科院分区：
文献类型：
--
作者：
Tsai, LM;Chao, TH;Chen, JH
研究目的：通过随访经食管超声心动图（TEE）评价慢性心房颤动（AF）患者左心房（LA）附属物血流速度的时间相关性变化，并探讨其与LA自发回声对比发生的关系。设计：前瞻性随访研究。环境：以大学为基础的三级转诊医疗中心。患者：47例慢性非风湿性房颤患者。干预措施：所有研究的患者在平均13 +/- 7个月期间接受了基线和随访TEE。测量和结果：基线TEE显示，28例患者（1组）存在LA自发回声造影剂，19例患者（2组）没有。基线时，1组的LA附属物血流速度曲线明显低于2组；随访时，2组患者附属物血流速度明显下降，1组无明显变化，随访TEE显示1组患者均持续自发性回声造影术。在2组中，9例患者（2A组）新观察到LA自发回声造影剂，10例患者（2B组）持续无回声造影剂。在2A组中，所有LA附属物血流速度谱在随访研究中均明显下降。而在2B组，只有LA附属物流入速度积分在随访中有明显下降；LA附属物流出速度指标和峰值流入速度无显著变化。结论：部分房颤患者LA附属物血流速度随时间降低，这种变化与LA自发回声造影术的新发生有关。对于没有LA自发性回声造影剂的患者，连续随访LA附件血流速度谱可能有助于预测未来自发回声造影剂的发展。AF患者一旦发生LA自发回声对比，往往会随着时间的推移而持续存在，并且LA附属物通常处于持续的低血流状态。
Study objectives: To evaluate the time-related change of left atrial (LA) appendage flow velocity in chronic atrial fibrillation (AF) by follow-up transesophageal echocardiography (TEE) and to investigate its association with the occurrence of LA spontaneous echo contrast.Design: Prospective follow-up study.Setting: University-based, tertiary referral medical center.Patients: Forty-seven patients with chronic nonrheumatic AF.Interventions: All studied patients underwent both a baseline and follow-up TEE during a mean period of 13 +/- 7 months.Measurements and results: Baseline TEE revealed that LA spontaneous echo contrast was present in 28 patients (group 1) and was absent in 19 patients (group 2), The LA appendage flow velocity profiles at baseline tr ere significantly lower in group 1 than in group 2; on follow-up, the appendage flow velocities decreased significantly in group 2, but were not significantly changed in group 1, Follow-up TEE revealed that spontaneous echo contrast was persistent in all group 1 patients. In group 2, LA spontaneous echo contrast was newly observed in 9 patients (group 2A) but was persistently absent in 10 patients (group 2B), In group 2A, all of the LA appendage flow velocity profiles decreased significantly at the follow-up study. In group 2B, however, only LA appendage inflow velocity integral showed significant decrease on follow-up; there were no significant changes in LA appendage outflow velocity indexes and peak inflow velocity.Conclusions: LA appendage flow velocity may decrease with time in some patients with AF, and this change is associated with a new occurrence of LA spontaneous echo contrast. For patients without LA spontaneous echo contrast, serial follow-up of the LA appendage flow velocity profiles may be useful for predicting future development of spontaneous echo contrast. Once LA spontaneous echo contrast occurs in AF patients, it tends to persist with time and the LA appendage is usually under a persistently low flow state.