Abstract：【Objective】To explore the significance of ultrasound cardiac structure in evaluation of non-valvular atrial fibrillation (AF) stroke risks. 【Methods】A total of 91 AF patients, including 38 cases with stroke and 53 cases without stroke were collected retrospectively. The data were compared to 102 recently recruited AF patients, who served as the control group. All the subjects above accepted ultrasonic cardiogram to detect right atrium diameter (RAD), interventricular septal thickness (IVS), left ventricular diameter (LVD), posterior wall of left ventricle (LVPW) and left atrium diameter (LAD). Further analysis of the correlation between clinic symptom scores (CHADS2 and CHA2DS2-VASc scores) and cardiac structural parameters in the control group were evaluated.【Results】The retrospective study indicated that IVS (OR=2.698,P=0.018), LVPW (OR=2.703,P=0.013) and LAD (OR=3.708,P=0.022) were the risk factors of stroke in AF patients. Our study also showed that RAD (rs=0.562,P=0.020), IVS (rs=0.497,P=0.013), LVPW (rs=0.398,P=0.046) and LAD (rs=0.701,P=0.007) were positively correlated with CHADS2 scores in AF patients. Similarly, positive correlations were found between CHA2DS2 - VASc scores and IVS (rs=0.668,P=0.019), LVPW (rs=0.481,P=0.032), LAD (rs=0.649,P=0.011). 【Conclusion】Indicators of ultrasound cardiac structure have a certain significance in predicting the risk of stroke in non-valvular atrial fibrillation patients.
[1]Wattigney WA, Meusab GA, Croft JB. Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999 implications for primary prevention [J].Circulation,2003, 108(6):711-716. [2] 杨俊,黄道远,陈力强,等.超声心动图指标与心房颤动患者血栓栓塞风险的相关性研究[J].临床和实验医学杂志,2015,14(6):471-474. [3] 张海芹,崔花花. CHADS2及CHA2DS2-VASc评分法对临床非瓣膜性心房纤颤抗栓疗效观察[J].中西医结合心脑结合病杂志,2014,7(11):327-329. [4] Melgaard L, Rasmussen LH, Skjth F,et al. Age dependence of risk factors for stroke and death in young patients with atrial fibrillation: a nationwide study [J].Stroke,2014,45(5):1331-1337. [5] 沈冶军,陈海洪,缪抱红,等.华法林钠片治疗心房颤动合并脑栓塞的临床疗效[J].湖南师范大学学报(医学版),2015,(4):112-114. [6] Saliba W, Gronich N, Barnett-Griness O, et al. Usefulness of CHADS2 and CHA2DS2-VASc Scores in the Prediction of New-Onset Atrial Fibrillation: A Population-Based Study [J].Am J Med,2016,129(8):843-849. [7] Decker JM, Madder RD, Hickman L, et al. CHADS2 score is predictive of left atrial thrombus on precardioversion transesophageal echocardiography in atrial fibrillation [J].Am J Cardiovasc Dis,2011,1(2):159 -165. [8] Lam CS, Grewal J, Borlaug BA, et al. Size, shape, and stamina: the impact of left ventricular geometry on exercise capacity [J].Hypertension,2010,55(5):1143 -1149. [9] Chrispin J, Jain A, Soliman EZ, et al. Association of electrocardiographic and imaging surrogates of left ventricular hypertrophy with incident atrial fibrillation: MESA (Multi-Ethnic Study of Atherosclerosis) [J].J Am Coll Cardiol,2014,63(19):2007-2013. [10] 马健超,潘宁,王薇,等.超声心动图评价高血压左心室肥厚与脑卒中相关性的研究[J].黑龙江医药科学,2015,38(1):42-45. [11] 王丽丽,刘强,赵有生,等.血清N-末端脑钠肽前体及脑利钠肽预测非瓣膜性房颤患者的栓塞危险性[J].广东医学,2010,31(13):1690-1691. [12] 范学慧,李涛,杨国强,等.心房颤动患者心脏功能变化的研究[J].重庆医学,2014,43(5):513-515. [13] Trambaiolo P, Salustri A, Tanga M, et al. Assessment of left atrial appendage wall velocities by transesophageal tissue Doppler echocardiography: a clinical study in patients with sinus rhythm [J].J Am Soc Echocardiogr,2002,15(5):425 -432.
2017, Vol. 34 
