Zhang Juan, Cui Cun-Ying, Huang Dan-Qing, Liu Yuan-Yuan, Qin Yun-Yun, Zhang Lian-Zhong, Liu Lin
Department of Cardiovascular Ultrasound, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Echocardiography. 2018 Jul;35(7):991-998. doi: 10.1111/echo.13870. Epub 2018 Apr 20.
The objective of this study was to evaluate the feasibility of online real time three-dimensional transesophageal echocardiography (RT3DTEE) in the measurement of left atrial appendage (LAA) orifice size. We also analyzed the correlation between LAA ejection fraction (EF) and its peak empty velocity (PEV).
There were 91 subjects enrolled in this study, with 46 patients with AF and 45 individuals with sinus rhythm (SR). RT3DTEE was performed by four methods including iSlice and iCrop online and QLAB software 3DQ and GI-3DQ off-line which were used to measure LAA orifice area, long diameter, short diameter, depth in the largest LAA, and number of LAA lobes. These LAA parameters achieved by the four methods were compared, respectively. GI-3DQ off-line was used to measure LAA end-diastolic and end-systolic volumes to calculate EF of LAA. Two-dimensional (2D) TEE was applied to measure PEV of LAA. The correlation between EF and PEV was analyzed.
There were no significant differences in all LAA parameters between any two RT3DTEE methods (All P > .05). There was a significant and positive correlation between PEV and EF (r = .423, P = .000). There were statistical differences in LAA EF and PEV between patients with AF and SR individuals (0.38 ± 0.12 vs 0.61 ± 0.07, 35.7 ± 12.1 vs 49.5 ± 10.0 cm/s, P = .000).
Using online RT3DTEE for measuring LAA orifice size is feasible, and online RT3DTEE is more convenient than offline RT3DTEE. EF is positively correlated with PEV. LAA function is significantly decreased in patients with AF.
本研究旨在评估在线实时三维经食管超声心动图（RT3DTEE）测量左心耳（LAA）开口大小的可行性。我们还分析了LAA射血分数（EF）与其峰值排空速度（PEV）之间的相关性。
本研究共纳入91名受试者，其中46例房颤患者和45例窦性心律（SR）个体。采用iSlice和iCrop在线以及QLAB软件3DQ和GI-3DQ离线四种方法进行RT3DTEE检查，测量LAA开口面积、长径、短径、最大LAA深度和LAA叶数。分别比较这四种方法获得的这些LAA参数。使用GI-3DQ离线测量LAA舒张末期和收缩末期容积以计算LAA的EF。应用二维（2D）TEE测量LAA的PEV。分析EF与PEV之间的相关性。
任何两种RT3DTEE方法之间的所有LAA参数均无显著差异（所有P>.05）。PEV与EF之间存在显著正相关（r =.423，P =.000）。房颤患者与SR个体之间的LAA EF和PEV存在统计学差异（0.38±0.12 vs 0.61±0.07，35.7±12.1 vs 49.5±10.0 cm/s，P =.000）。
使用在线RT3DTEE测量LAA开口大小是可行的，且在线RT3DTEE比离线RT3DTEE更方便。EF与PEV呈正相关。房颤患者的LAA功能显著降低。
