Ito Y, Arakawa M, Noda T, Miwa H, Kagawa K, Nishigaki K, Fujiwara H
Second Department of Internal Medicine, Gifu University School of Medicine, Japan.
Heart Vessels. 1996;11(1):30-8. doi: 10.1007/BF01744597.
Atrial reservoir function has not been studied after successful cardioversion of chronic atrial fibrillation. Using transthoracic and transesophageal Doppler echocardiography, we measured flow velocity-time integrals of the systolic forward (Sa), diastolic forward (Da), and diastolic reversed (rAa) waves of flow velocity waveforms in the pulmonary vein and the superior vena cava, and those of the early diastolic (Ea) and late diastolic (Aa) waves of the transmitral and transtricuspid flow velocity waveforms. The left and right atrial storage fractions (LASF, RASF), indexes of atrial reservoir function, were determined as the ratios of the atrial storage volume to the ventricular stroke volume; (Sa - rAa)/(Sa - rAa + Da). The left and right atrial active contraction fractions (LAACF, RAACF), indexes of atrial active transport function, were also determined as the ratios of the atrial active contraction volume to the left ventricular stroke volume; Aa/(Ea + Aa). These indices were evaluated periodically in 12 patients with non-valvular chronic atrial fibrillation before and 1-4 days after direct current cardioversion of atrial fibrillation; in 8 of the patients, the indices were also evaluated 1-3 months after the cardioversion. An additional 10 patients in sinus rhythm served as controls. Both the LASF and RASF were low during atrial fibrillation; the values increased significantly 14 days after successful cardioversion (P < 0.01 P < 0.01), and continued to increase at 1-3 months. The LASF and RASF values 1-3 months after cardioversion were comparable to those in control subjects. Both the LAACF and RAACF also increased significantly from 1-4 days to 1-3 months after cardioversion (P < 0.05, P < 0.01), becoming comparable to those in control subjects. During the 3 months after successful cardioversion of non-valvular chronic atrial fibrillation, left and right atrial reservoir function and left and right atrial active transport function increased progressively, becoming comparable to values in the control subjects.
慢性心房颤动成功复律后，心房储血功能尚未得到研究。我们采用经胸和经食管多普勒超声心动图，测量了肺静脉和上腔静脉血流速度波形的收缩期正向波（Sa）、舒张期正向波（Da）和舒张期逆向波（rAa）的流速时间积分，以及二尖瓣和三尖瓣血流速度波形的舒张早期波（Ea）和舒张晚期波（Aa）的流速时间积分。心房储血分数（LASF、RASF）作为心房储血功能指标，通过心房储血量与心室每搏量的比值来确定；（Sa - rAa）/（Sa - rAa + Da）。心房主动收缩分数（LAACF、RAACF）作为心房主动转运功能指标，也通过心房主动收缩量与左心室每搏量的比值来确定；Aa/（Ea + Aa）。对12例非瓣膜性慢性心房颤动患者在心房颤动直流电复律前及复律后1 - 4天定期评估这些指标；其中8例患者在复律后1 - 3个月也进行了评估。另外10例窦性心律患者作为对照。心房颤动期间LASF和RASF均较低；成功复律后14天这些值显著升高（P < 0.01，P < 0.01），并在1 - 3个月持续升高。复律后1 - 3个月的LASF和RASF值与对照受试者相当。复律后1 - 4天至1 - 3个月，LAACF和RAACF也显著升高（P < 0.05，P < 0.01），与对照受试者相当。在非瓣膜性慢性心房颤动成功复律后的3个月内，左右心房储血功能和左右心房主动转运功能逐渐增强，与对照受试者的值相当。
