目的 通过经胸超声心动图（Trans-Thoracil Echocardiography，TTE）检测阵发性房颤 （Atrial Fibrillation，AF）患者相关参数来评估患者左心耳血流速度（Left Atrial Appendage Flow Velocity，LAA-FV）。方法 研究对象为90例非瓣膜阵发性房颤患者，在TTE和经食管超声心 动图（TEE）检测期间为窦性心律，评估所有患者超声心动图和临床相关参数。结果 LAA-FV （61±23）cm/s和心电图上P波与TTE上二尖瓣血流A波起始时间间隔（PA-TMF，相关系数： ?0.33；P<0.001）、左心房内径（LAD，相关系数：?0.32；P<0.001）、组织多普勒超声室间隔 a’速度（TDI，相关系数：0.36；P<0.001）、E/e’比值（相关系数：?0.27，P<0.001）、二尖瓣血 流E峰速度（相关系数：?0.21，P=0.007）、二尖瓣血流E/A比值（相关系数：?0.17，P=0.04）、 CHA2DS2-VASc评分（相关系数：?0.14，P=0.03）和血浆B型钠尿肽（BNP）水平（?0.33， P=0.003）密切相关。多因素分析显示，PA-TMF（标准化回归系数：?0.16；P=0.04）、a’速度 （标准化回归系数：0.25，P=0.005）和LAD（标准化回归系数：?0.21；P=0.02）是LAA-FV独立 预测因子（多重相关系数：0.43；P<0.001）。结论 心房重构相关参数，如降低的a’速度、增加的 LAD及PA-TMF期间窦性心律可以预测阵发性AF患者左心房淤血状况。

Objective To estimate the left atrial appendage flow velocity (LAA-FV) with clinical parameters, which were noninvasively detected in patients with paroxysmal atrial fibrillation (AF) via trans-thoracic echocardiography (TTE). Methods Trans-esophageal echocardiography (TEE) and TTE examinations were simultaneously performed in 90 cases of patients with non-valvular paroxysmal AF during the period of showing sinus rhythm, thereby to assess the obtained echocardiography and clinical parameters. Results LAA-FV (61±23) cm/s was significantly correlated with the time interval between the initiation of P-wave on electrocardiogram (ECG) and that of A-wave of transmitral flow on TTE (PATMF, r=?0.33, P<0.001), left atrial diameter (LAD, r=?0.32, P<0.001), ventricular septal a’ velocity via tissue Doppler imaging (TDI, r=0.36, P<0.001), E/e’ratio (r=?0.27, P<0.001), E velocity of transmitral flow (r=?0.21, P=0.007), E/A ratio of transmitral flow (r=?0.17, P=0.04), CHA2DS2-VASc score (r=?0.14, P=0.03) and plasma B-type natriuretic peptide (BNP) level (r=?0.33, P=0.003). Multivariate analysis revealed that PA-TMF (standardized regression coefficient γ=?0.16, P=0.04), a’velocity (γ=0.25, P=0.005) and LAD (γ=?0.21, P=0.02) were independent predictors of LAA-FV (multiple correlation coefficient R=0.43; P<0.001). Conclusion Clinical parameters of atrial remodeling, such as decreased a’velocity, increased LAD and PA-TMF under sinus rhythm, could be regarded as useful predictors of left atrial blood stasis in patients with non-valvular paroxysmal AF.