超声心动图预测非瓣膜性心房颤动患者发生左心耳血栓状态的临床价值

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ABSTRACTObjectiveToinvestigate theclinical valueof echocardiographyinpredicting leftatrialappendage thrombogenic milieu（LAATM）inpatientswithnon-valvularatrial fibrilation（NVAF）.MethodsAtotalof329 patients diagnosedas NVAF inour hospital wereenroled.Allpatientsunderwent transthoracicechocardiographyandtransesophageal echocardiography.Basedonleftatrialappendage findings，patients were divided intothe LAATM group（62cases）andthe nonLAATM group（267 cases）.Diferences in clinical dataandechocardiographic examinationsbetween the two groups were compared.MultivariateLogisticregressionanalysiswasusedtoidentifyindependentinfluencingfactors inpredictingLAATMin NVAF patients.Receiveroperatingcharacteristic（ROC）curves weredrawn toanalyzethediagnosticeficacyof individualand combinedapplicationof influencingfactorsinpredictingtheoccurrenceofLAATMinNVAFpatients.ResultsSignificant diferences wereserdinage，roportionofpersistentatrialibriltion，CHA-VAc-6Osore，leftatrialnteroteio diameter，leftatrialmediolateraldiameter，leftatrialsuperoinferiordiameter，leftventricularend-diastolicdiameter，left ventricularend-systolicdiameter，leftventricularjectionfraction，leftatrialappendageorificewidth，leftatrialapendage depth，and proportion of patientswith reduced left atrial appendage emptying velocity between the two groups（all P<0.05 ）. MultivariateLgisticegresioaalysisshowedtatleftatrialmediolateraldiameter，leftatrialappendgedepth，ndduced leftatrialappendage emptying velocitywere theindependentinfluencing factors in predicting LAATMinNVAFpatients（ OR= （20

1.168，1.120，13.728，all P <0.05）.ROC curve analysis showed that the area under the curves of left atrial mediolateral diameter， leftatrialappendagedepth，andreducedleftatrialappendageemptyingvelocity，aswellastheircombinedapplication，for predicting theoccurrenceofLAATMinNVAFpatientswere0.804，0.637，0.829，and0.906，respectively.Thecombined application yielded the highest area under the curve，with a corresponding sensitivity of 83.9% and specificity of 88.8% ConclusionTransthoracic echocardiographycombined with transesophageal echocardiographyhas significant clinicalvaluein predictingLAATM inNVAF patients.

KEYWORDSEchocardiography，transthoracic，transesophageal;Non-valvularatrialfibrilation;Leftatrialappendage thrombogenic milieu

非瓣膜性心房颤动（non-valvularatrialfibrillation，NVAF是最常见的心房颤动（以下简称房颤）类型，而房颤是缺血性脑卒中的重要危险因素，其导致患者脑卒中风险增加5倍，死亡率增加2倍[1]。（剩余8287字）