心房颤动患者左心房功能多排CT与超声心动对照研究
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摘要
目的:以实时三维超声心动图(RT-3DE)为参照,探讨多排CT(MDCT)对心房颤动患者左心房容积和功能评估的准确性,以期心房颤动患者在冠状动脉CTA检查时能够可靠、便捷地评价左心房功能。方法:132例患者,3年内完成MDCT和RT-3DE检查,然后对原始数据进行后处理及分析。重建获得左心房三维容积图像,测量左心房最大容积(LAV max)、左心房最小容积(LAV min),并计算LAEF。通过ICC检验分析MDCT观察者间及观察者内一致性,配对t检验分析MDCT和RT-3DE两种检查方法间的差异。结果:MDCT对左心房容积和功能测量值观察者间及观察者内均具有高度重现性(ICC>0.75)。MDCT和RT-3DE对左心房容积和功能测量指标之间差异无统计学意义(P>0.05),同时MDCT和RT-3DE对左心房容积和功能测量结果具有高度重现性(ICC>0.75)。结论:MDCT能够在评估冠状动脉同时,准确测量左心房容积和功能,能够为心房颤动患者评价提供全面的解剖及功能学信息。
Objective: This study was designed to compare the accuracy of multi-detector computed tomography(MDCT) for left atrium(LA) volume and function assessment with real-time 3 dimensional echocardiography(RT-3 DE).Method :A total of 132 patients underwent MDCT and RT-3 DE examinations within three years week.LAVmax,LAVmin,and LAEF data were obtained.Consistency between and within the observers of MDCT was analyzed by ICC test. Difference between MDCT and RT-3 DE was tested through paired t test. Result :Good agreement for LA volume and LAEF assessment was acquired between and within the observers of MDCT(ICC>0.75).For LAVmax,LAVmin,and LAEF measurements,there was no significant difference between MDCT and RT-3 DE method(P>0.05).Good agreement for LA volume and LAEF assessment was acquired between MDCT and RT-3 DE(ICC>0.75). Conclusions: MDCT can examine coronary artery and cardiac function at the same time.It can provide highly reliable measurements of LA volume and function and information.
Objective: This study was designed to compare the accuracy of multi-detector computed tomography(MDCT) for left atrium(LA) volume and function assessment with real-time 3 dimensional echocardiography(RT-3 DE).Method :A total of 132 patients underwent MDCT and RT-3 DE examinations within three years week.LAVmax,LAVmin,and LAEF data were obtained.Consistency between and within the observers of MDCT was analyzed by ICC test. Difference between MDCT and RT-3 DE was tested through paired t test. Result :Good agreement for LA volume and LAEF assessment was acquired between and within the observers of MDCT(ICC>0.75).For LAVmax,LAVmin,and LAEF measurements,there was no significant difference between MDCT and RT-3 DE method(P>0.05).Good agreement for LA volume and LAEF assessment was acquired between MDCT and RT-3 DE(ICC>0.75). Conclusions: MDCT can examine coronary artery and cardiac function at the same time.It can provide highly reliable measurements of LA volume and function and information.
引文
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[13] Atar E.Coronary computed tomography with lower radiation dose.Isr Med Assoc J,2011;13:564-565.
[14] Durmus T,Rogalla P,Lembcke A,et al.Low-dose triple-rule-out using 320-row-detector volume MDCT — less contrast medium and lower radiation exposure.Eur Radiol,2011,21:1416-1423.
[15] Ko SM,Kim YJ,Park JH,et al.Assessment of left ventricular ejection fraction and regional wall motion with 64-slice multidetector CT:A comparison with two-dimensional transthoracic echocardiography.Br J Radiol,2010,83:28-34.
[16] Ichikawa Y,Sakuma H,Kitagawa K,et al.Evaluation of left ventricular volumes and ejection fraction using fast steady-state cine MR imaging:Comparison with left ventricular angiography.J Cardiovasc Magn Reson,2003,5:333-342.
[17] Sugeng L,Mor-Avi V,Weinert L,et al.Quantitative assessment of left ventricular size and function:Side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference.Circulation,2006,114:654-661.
[18] Yamamuro M,Tadamura E,Kubo S,et al.Cardiac functional analysiswith multi-detector row CT and segmental reconstruction algorithm:comparison with echocardiography,SPECT,and MR imaging.Radiology,2005,234:381-390.
[2] Roh SY,Shim J,Lee KN,et al.Gender-related difference in clinical outcome of the patient with atrial fibrillation after radiofrequency catheter ablation.Korean Circ J,2018,48(7):605-618.
[3] Stojanovska J,Cronin P,Gross BH,et al .Left atrial function and maximum volume as determined by MDCT are independently associated with atrial fibrillation[J].Radiology,Acad Radiol,2014,21(9):1162-1171.
[4] Beinart R,Boyko V,Schwammenthal E,et al.Long-term prognostic significance of left atrial volume in acute myocardial infarction [J].J Am Coll Cardiol,2004,44(2):327-334.
[5] Di LZ,Pichette M,Nadeau R,et al.Severe Bradyarrhythmia linked to left atrial dysfunction in fabry disease- a cross-sectional study:cross-sectional analysis of the clinical,electrocardiographic and echocardiographic determinants of bradyarrhythmic events in patients with fabry disease- the impact of left atrial function.Clin Cardiol,2018,30.
[6] Marwick TH,Sharman JE.Arterial loading and the prevention of atrial dysfunction.Circ Cardiovasc Imaging,2017,10(6):e006546.
[7] Thomas L.Assessment of atrial function[J].Heart,Lung and Circulation,2007,16(3):234-242.
[8] Nagarakanti R,Slee A,Saksena S.Left atrial reverse remodeling and prevention of progression of atrial fibrillation with atrial resynchronization device therapy utilizing dual-site right atrial pacing in patients with atrial fibrillation refractory to antiarrhythmic drugs or catheter ablation[J].J Interv Card Electrophysiol,2014,40(3):245-254.
[9] Vermond RA,Geelhoed B,Verweij N,et al.Incidence of atrial fibrillation and relationship with cardiovascular events,heart failure,and mortality:a community-based study from the netherlands.J Am Coll Cardiol,2015,66(9):1000-7.
[10] Saraiva RM,Yamano T,Matsumura Y,et al .Left atrial function assessed by real-time 3-dimensional echocardiography is related to right ventricular systolic pressure in chronic mitral regurgitation[J] .Am Heart J,2009,158(2):309-316.
[11] Anwar AM,Geleijnse ML,Soliman OI,et al .Left atrial frank-starling law assessed by real-time,three-dimensional echocardiographic left atrial volume changesp[J].Heart,2007,93(11):1993-1397.
[12] 包洪靖,陈莉,屈丰华,等.实时三维超声心动图在评估心梗患者左心功能的应用价值[J].医学影像学杂志,2012,22(1):39-42.
[13] Atar E.Coronary computed tomography with lower radiation dose.Isr Med Assoc J,2011;13:564-565.
[14] Durmus T,Rogalla P,Lembcke A,et al.Low-dose triple-rule-out using 320-row-detector volume MDCT — less contrast medium and lower radiation exposure.Eur Radiol,2011,21:1416-1423.
[15] Ko SM,Kim YJ,Park JH,et al.Assessment of left ventricular ejection fraction and regional wall motion with 64-slice multidetector CT:A comparison with two-dimensional transthoracic echocardiography.Br J Radiol,2010,83:28-34.
[16] Ichikawa Y,Sakuma H,Kitagawa K,et al.Evaluation of left ventricular volumes and ejection fraction using fast steady-state cine MR imaging:Comparison with left ventricular angiography.J Cardiovasc Magn Reson,2003,5:333-342.
[17] Sugeng L,Mor-Avi V,Weinert L,et al.Quantitative assessment of left ventricular size and function:Side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference.Circulation,2006,114:654-661.
[18] Yamamuro M,Tadamura E,Kubo S,et al.Cardiac functional analysiswith multi-detector row CT and segmental reconstruction algorithm:comparison with echocardiography,SPECT,and MR imaging.Radiology,2005,234:381-390.