超声心动图评价左房形态和功能的临床应用进展

左房形态和功能既可反映机体的生理状态,也可反映其病理状态,左房形态和功能异常改变是冠心病、高血压、心血管硬化、中风等诸多心血管疾病的早期表现之一,是心血管死亡、心肌梗死、卒中、心力衰竭等不良心血管事件的危险因素之一,与这类疾病的预后密切相关,因而准确、有效评估左房形态和功能在不良心血管事件的诊疗及预后评估中意义重大。采用超声心动图评价左房形态和功能具有无创、实时高效、价格低廉及可重复性高等优点,临床上应用非常广泛。随着超声技术的进步,除二维超声心动图、彩色多普勒超声心动图等常规超声技术外,组织多普勒显像(TDI)技术、由TDI派生出来的应变及应率显像技术、实时三维超声心动图(RT-3DE)、二维斑点追踪成像(2D-STI)技术、三维斑点追踪成像(3D-STI)技术等新型超声技术也逐渐应用于左房形态、功能的评价中,然而不同的超声技术评价左房形态和功能仍有一定的不足之处,本研究就不同超声心动图评价左房形态和功能的临床应用及研究进展进行综述。

Clinical Application of Echocardiography in Evaluating Left Atrial Morphology and Function

ABSTRACT: The morphology and function of the left atrium can not only reflect the physiological state of the body, but also reflect the pathological state. The abnormal changes of the left atrial form and function are one of the early manifestations of coronary heart dis- ease, hypertension, cardiovascular sclerosis, stroke and many other cardiovascular diseases. They are one of the risk factors of cardiovas- cular death, myocardial infarction, stroke, heart failure and other adverse cardiovascular events and are closely related to the prognosis of these diseases, therefore, accurately and effectively assessing the morphology and function of the left atrial is of great significance in the diagnosis, treatment and prognosis of adverse cardiovascular events. Echocardiographic assessment of left atrial morphology and function has the advantages of noninvasive, real-time, high efficiency, low cost and high repeatability and it is widely used in clinical practice.With the progress of ultrasonic technology, in addition to two-dimensional echocardiography, color Doppler echocardiography and con- ventional ultrasound technology, the tissue Doppler imaging (TDI), strain and stress imaging derived from TDI, real-time three dimensional echocardiography (RT-3DE), 2D-speckle speckle tracking imaging (2D-STI), 3D-speckle tracking imaging (3D-STI) and other new ultra- sound techniques are gradually applied to the evaluation of left atrial morphology and function. However, there are still some deficiencies in the evaluation of left atrial morphology and function by different ultrasound techniques. This study reviews the clinical application and research progress of different echocardiographic evaluation of left atrial morphology and function.