Tabata T, Oki T, Iuchi A, Yamada H, Manabe K, Fukuda K, Abe M, Fukuda N, Ito S
Second Department of Internal Medicine, Tokushima University School of Medicine, Japan.
Am J Cardiol. 1997 Mar 1;79(5):615-20. doi: 10.1016/s0002-9149(96)00826-0.
We investigated temporary changes in left atrial appendage (LAA) flow velocity patterns in patients undergoing electrical cardioversion for chronic isolated atrial fibrillation, and evaluated the role of active LAA contraction in directing blood flow to the left atrial main chamber and left ventricle. The study consisted of 26 patients with chronic isolated atrial fibrillation treated with electrical cardioversion and 20 normal controls in sinus rhythm. Using transthoracic and transesophageal Doppler echocardiography, we recorded transmitral, pulmonary venous, and LAA flow velocity patterns before, 24 hours, and 1 week after cardioversion in all subjects. In the 15 patients who underwent successful cardioversion, the maximal LAA area 24 hours after cardioversion was smaller than the area before cardioversion, whereas LAA ejection fraction during atrial systole and peak atrial systolic emptying velocity of the LAA flow were lower 24 hours after cardioversion than those in the control group. One week after cardioversion, maximal LAA area and LAA peak atrial systolic emptying velocity were restored to levels approximately equivalent to those in the control group, although LAA ejection fraction was lower than in the control group. Maximal LAA area and LAA peak atrial systolic emptying velocity correlated negatively and positively with LAA ejection fraction, respectively, 24 hours and 1 week after cardioversion. These results suggest that LAA and the left atrial main chamber show stunning 24 hours after cardioversion, and the atrial systolic emptying wave of LAA flow is generated by active LAA contraction.
我们研究了接受电复律治疗慢性孤立性心房颤动患者左心耳（LAA）血流速度模式的暂时变化，并评估了LAA主动收缩在引导血流至左心房主腔和左心室中的作用。该研究包括26例接受电复律治疗的慢性孤立性心房颤动患者和20例窦性心律的正常对照者。使用经胸和经食管多普勒超声心动图，我们记录了所有受试者在复律前、复律后24小时和1周时的二尖瓣、肺静脉和LAA血流速度模式。在15例复律成功的患者中，复律后24小时LAA最大面积小于复律前，而复律后24小时心房收缩期LAA射血分数和LAA血流的心房收缩期峰值排空速度低于对照组。复律后1周，LAA最大面积和LAA心房收缩期峰值排空速度恢复到与对照组大致相当的水平，尽管LAA射血分数低于对照组。复律后24小时和1周时，LAA最大面积与LAA射血分数呈负相关，LAA心房收缩期峰值排空速度与LAA射血分数呈正相关。这些结果表明，复律后24小时LAA和左心房主腔出现顿抑，LAA血流的心房收缩期排空波由LAA主动收缩产生。
