Lin J M, Hsu K L, Hwang J J, Tseng Y Z
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
Cardiology. 1997 Nov-Dec;88(6):563-8. doi: 10.1159/000177420.
The function of the left atrial appendage (LAA) reflected by the Doppler flow velocity at the outlet of the left atrial appendage has been reported to be correlated with spontaneous echo contrast and thrombus formation. To evaluate the influence of left ventricular diastole on LAA flow during atrial fibrillation (AF), 81 patients with chronic nonrheumatic AF were studied by transesophageal echocardiography. The peak outflow velocity of LAA during ventricular diastole was higher than that during ventricular systole (0.23 +/- 0.14 vs. 0.15 +/- 0.13 m/s, p < 0.001). The peak inflow velocity of LAA during ventricular diastole was also higher than that during ventricular systole (0.22 +/- 0.15 vs. 0.18 +/- 0.11 m/s, p < 0.01). Patients with a good left ventricular ejection fraction have a significantly higher peak LAA outflow velocity and a larger diastolic augmentation of LAA outflow (defined by the difference of LAA outflow between systolic and diastolic phases) than patients with an impaired left ventricular function. Thus, left ventricular diastole might have an influence on LAA flow during AF. In addition, the left ventricular function might be considered a predictor of subsequent thromboembolism from the viewpoint of its effect on LAA flow in patients with nonrheumatic AF.
据报道，左心耳出口处多普勒血流速度所反映的左心耳（LAA）功能与自发显影及血栓形成相关。为评估心房颤动（AF）期间左心室舒张对LAA血流的影响，采用经食管超声心动图对81例慢性非风湿性AF患者进行了研究。心室舒张期LAA的峰值流出速度高于心室收缩期（0.23±0.14对0.15±0.13m/s，p<0.001）。心室舒张期LAA的峰值流入速度也高于心室收缩期（0.22±0.15对0.18±0.11m/s，p<0.01）。左心室射血分数良好的患者，其LAA峰值流出速度显著更高，且LAA流出的舒张期增加幅度（由收缩期和舒张期LAA流出的差值定义）大于左心室功能受损的患者。因此，左心室舒张可能对AF期间的LAA血流有影响。此外，从其对非风湿性AF患者LAA血流的影响来看，左心室功能可能被视为后续血栓栓塞的一个预测指标。
