目的：应用实时三平面自动功能成像（AFI）及应变率成像（SRI）技术分别评价阵发性心房颤动(PAF)患者左心室及左心房功能的变化。方法对PAF患者36例（PAF组）及健康志愿者30例（对照组）进行常规（二维）超声心动图检查，测定左心房内径（LAD）及舒张早期二尖瓣跨瓣血流速度（E），运用组织速度成像（TVI）在心尖四腔心切面测得左心室室间隔和侧壁舒张期峰值速度，获得其平均值Em，并计算E/Em值；应用AFI技术测量并比较两组左心室17节段的纵向收缩峰值应变（RLS）及整体纵向收缩峰值应变（GLS）；应用SRI技术获得左心房的应变率曲线并测量左心房各壁中间段及心底段收缩期、舒张早期、心房收缩期峰值应变率（SRs、SRe、SRa），计算其平均值（mSRs、mSRe、mSRa）。结果与对照组比较，PAF组LAD增大，E、E/Em升高，Em、LVEF降低（P＜0.01）；PAF组左心室前壁、侧壁、后壁、下壁的基底段RLS较对照组虽有减低，但差异均无统计学意义（均P＞0.05），其余节段RLS、心脏整体应变均不同程度减低（P＜0.05或0.01）；PAF组mSRs、mSRe、mSRa减低（均P＜0.01）。结论 AFI及SRI对全面评价PAF左心房及左心室功能的改变具有重要的应用价值。%Objective To evaluate the changes of left atria and ventricular functions by using real- time triplane automated function imaging (AFI) and real- time triplane strain rate imaging (SRI) in patients with paroxysmal atrial fibril ation (PAF) . Meth-ods Thirty six patients with PAF (PAF group) and 30 healthy subjects (control group) were enrol ed in the study. Conventional e-chocardiographic examination was performed. The early diastolic mitral transvalvular flow velocity (E), diastolic peak velocity of ventricular septum and left ventricle lateral wal were measured using tissue velocity imaging (TVI);the average (Em) was obtained and E/Em was calculated. The LV 17 segments systolic longitudinal strain (RLS) and the global systolic longitudinal strain (GLS) were measured with AFI. Systolic peak strain rate, early diastolic strain rate and late diastolic strain rate were measured in each LA segment, the average strain rate (mSRs, mSRe, mSRa) was calculated. Results Compared with control group, the LAD, E and E/Em were significantly increased in PAF group, Em and EF was significantly decreased (P<0.01). Compared to control group the basal segment of anterior, lateral, posterior, inferior wal RLS in PAF group presented no significant difference (P>0.05);while the systolic longitudinal strain (RLS) of the remaining segments, GLPS- Avg in PAF group were decreased (P<0.05 or 0.01);mSRs, mSRe and mSRa were also significantly decreased (P<0.01). Conclusion Automated function imaging (AFI) and real- time tri-plane strain rate imaging (SRI) are of value in evaluation of left ventricular and left atrial function in patients with paroxysmal atrial fibril ation.
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