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首页> 外文期刊>The American Journal of Cardiology >Correlation of echocardiographic left atrial abnormality with myocardial ischemia during myocardial perfusion assessment in patients with left bundle branch block
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Correlation of echocardiographic left atrial abnormality with myocardial ischemia during myocardial perfusion assessment in patients with left bundle branch block

机译：左束支传导阻滞患者心肌灌注评估中超声心动图左心房异常与心肌缺血的相关性

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摘要

Left atrial (LA) abnormality, an easily quantifiable parameter of left ventricular (LV) diastolic dysfunction, has been associated with cardiovascular risk. Because during myocardial perfusion study (MPS), the abnormal LV activation pattern in patients with left bundle branch block (LBBB) frequently induces perfusion defects, a clinical correlate of early myocardial ischemia such as LA enlargement could alleviate some of these inherent challenges. We prospectively studied 144 consecutive patients with LBBB who underwent MPS after screening for electrocardiographic and echocardiographic LA enlargement over a 6-month period. Of those, 114 had a positive MPS result. We found that LA size (p <0.0001) and P-wave duration (p = 0.001) were significantly increased in patients as the severity of the defects increased on MPS, whereas LV ejection fraction was decrementally reduced (p = 0.001). Importantly, LA size (≥43.5 mm; sensitivity 70%, specificity 89%) and P-wave duration (≥135 milliseconds; sensitivity 63%, specificity 90%) were greatest when the MPS defect was severe. In conclusion, the presence of LA enlargement appears significantly correlated with myocardial ischemia among patients with LBBB and could therefore assist during MPS interpretation among patients in whom MPS interpretation could be challenging.
机译：左心房（LA）异常是左心室（LV）舒张功能障碍的一个易于量化的参数，与心血管疾病风险相关。因为在心肌灌注研究（MPS）期间，左束支传导阻滞（LBBB）患者的异常LV激活模式经常诱发灌注缺陷，所以早期心肌缺血的临床相关因素（例如LA增大）可以缓解其中的一些固有挑战。我们前瞻性地研究了144例连续LBBB患者，这些患者经过6个月的心电图和超声心动图LA增大筛查后接受了MPS。其中有114例MPS结果为阳性。我们发现，随着MPS缺陷严重程度的增加，患者的LA大小（p <0.0001）和P波持续时间（p = 0.001）显着增加，而左室射血分数却逐渐降低（p = 0.001）。重要的是，当MPS严重时，LA大小（≥43.5mm;灵敏度70％，特异性89％）和P波持续时间（≥135毫秒;灵敏度63％，特异性90％）最大。总之，在LBBB患者中，LA增大的出现与心肌缺血密切相关，因此在MPS解释可能具有挑战性的患者中，MPS解释期间可能会有所帮助。

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