Narumiya Tatsuyoshi, Sakamaki Tatsuo, Sato Yuichi, Kanmatsuse Katsuo
Department of Cardiology, Nihon University Surugadai Hospital, Tokyo, Japan.
Circ J. 2003 Jan;67(1):68-72. doi: 10.1253/circj.67.68.
The relationship between the left atrial appendage (LAA) function, as assessed by transesophageal echocardiography, and the incidence of left atrial thrombus was evaluated in 62 patients with nonvalvular chronic atrial fibrillation (AF; n=50) and atrial flutter (AFL; n=12). It was hypothesized that in both AF and AFL not only the LAA flow velocity (LAAFV), but also the frequency of the LAA movement (the LAA flow time, LAAFT) is a major contributing factor to thrombus formation. LAAFT was defined as the average duration of LAA flow with emptying and filling waves. The patients with AF were divided into 2 groups: lone AF (n=14) and non-lone AF (n=36). LAA thrombus was found in 6 patients with none-lone AF. LAAFV was lower and LAAFT was shorter in patients with thrombus as compared with patients without thrombus (12.0+/-2.2 cm/s vs 24.1+/-10.6 cm/s, 68.7+/-1.5 ms vs 72.9+/-3.3 ms, p<0.01, respectively). Patients with AFL had higher LAAFV and longer LAAFT than those with chronic AF. The present data suggest that, in addition to LAAFV, LAAFT characterized LAA function and might serve as a predictor of thrombus formation in chronic AF. With respect to LAA function, patients with lone AF or AFL are at low risk for thrombus formation.
通过经食管超声心动图评估左心耳（LAA）功能与左心房血栓发生率之间的关系，对62例非瓣膜性慢性心房颤动（AF；n = 50）和心房扑动（AFL；n = 12）患者进行了研究。研究假设在AF和AFL中，不仅LAA流速（LAAFV），而且LAA运动频率（LAA流动时间，LAAFT）都是血栓形成的主要促成因素。LAAFT定义为LAA排空和充盈波的平均流动持续时间。AF患者分为2组：孤立性AF（n = 14）和非孤立性AF（n = 36）。在6例非孤立性AF患者中发现了LAA血栓。与无血栓患者相比，有血栓患者的LAAFV较低，LAAFT较短（分别为12.0±2.2 cm/s对24.1±10.6 cm/s，68.7±1.5 ms对72.9±3.3 ms，p<0.01）。AFL患者的LAAFV高于慢性AF患者，LAAFT更长。目前的数据表明，除LAAFV外，LAAFT也可表征LAA功能，并可能作为慢性AF中血栓形成的预测指标。就LAA功能而言，孤立性AF或AFL患者血栓形成风险较低。
