| Part one Quantitative study of left atrial appendage dimensions and volume with atrial fibrillation patients by cardiac CTAObjective: Using 256 slice spiral cardiac CTA measured quantitatively diameter and volume of the left atrial appendage with and without atrial fibrillation patients and preliminarily evaluated clinical significance of the changes of left atrial appendage anatomy in atrial fibrillation patients?Metholds: In the population of patients referred to our hospital for conventional 256 slice spiral CT coronary angiography,there were 140 atrial fibrillation patients(85 males and 55 females;mean age 60.00±14.00 years)in experimental group,and 64 patients without atrial fibrillation(40 males and 24 females;mean age 57.50±6.00 years)in control group,who were sinus rhythm,normal blood pressure(<140 / 90mmHg),without heart valve disease,coronary heart disease and other cardiovascular diseases.The original images obtained were processed by special cardiac function measurement software.Left atrial appendage orifice long axis,short axis,area and perimeter,depth,volume and the left atrial volume were measured and analyzed statistically.Results:1.There were no significant difference in gender,age,BMI index between experimental group and control group(P>0.05).2.The left atrial appendage orifice short axis,volume and the left atrial volume in experimental group had significantly larger than control group(P<0.05),but the left atrial appendage orifice long axis,area,perimeter and depth did not differ obviously(P>0.05).3.No statistical difference of the left atrial appendage orifice short axis,long axis,area,perimeter,depth,volume and the left atrial volume were observed between female and male group.After the given date standardization by body surface area,the left atrial appendage orifice short axis,long axis,area,perimeter,depth and the left atrial volume of female were bigger than male(P<0.05),but left atrial appendage volume between the two groups also showed had no statistic significance(P>0.05).Conclusion: The parameters of left atrial appendage could be meatured objectively by multislice spiral CT cardiac imaging.The left atrial appendage volume of atrial fibrillation patients increased in size and the left atrial appendage diameters were related to gender except its volume which may provide science guidance to treat patients with atrial fibrillation by radiofrequency ablation therapy and percutaneous occlusion,and also had better clinic value to discuss the occurring mechanism of left atrial appendage thrombosis.Part two Quantitative study of relationship between left atrial appendage and adjacent anatomical structure with atrial fibrillation patients by cardiac CTAObjective: Using 256 slice spiral cardiac CTA measured the quantitatively relationship and diameter between left atrial appendage(LAA)and adjacent anatomical structure for with and without atrial fibrillation(AF)patients to preliminarily provide anatomical date and clinical value for left atrial appendage occlusion and radiofrequency ablation in atrial fibrillation patients.Metholds: In the population of patients referred to our hospital for conventional 256 slice spiral CT coronary angiography,there were 94 AF patients(56 males and 38 females;mean age 57.46±11.68 years)in experimental group,and 80 patients without AF(44 males and 36 females;mean age 56.10±7.83 years)in control group,who were without heart valve disease,coronary heart disease and other cardiovascular diseases.The original images obtained were processed by special cardiac function measurement software.The types of LAA ridge,length of LAA ridge,the lengths of superior border,middle part and inferior margin of the LAA ridge,the minimum distances from LAA to Left superior pulmonary vein(LSPV)and to left circumflex artery,and the distance from LAA ostium to LSPV ostium and to mitral annulus were measured and analyzed statistically.Results :1.The general clinical data included gender,age,height,and weight between experimental group and control group,and the weight in experimental group was larger than the control group(P<0.05).2.Among the types of LAA ridge of AF group,the proportion of type AI?type A?and type C was lower than the control group,but the type B is higher.The left atrial appendage orifice short axis,volume and the left atrial volume in experimental group had significantly larger than control group(P<0.05).,but the left atrial appendage orifice long axis,area,perimeter and depth.3.After the given date standardization by body surface area,the lengths of middle part and inferior margin of the LAA ridge did not differ obviously(P>0.05),but the minimum distances from LAA to LSPV,the distance from LAA ostium to LSPV ostium and to mitral annulus in AF group were longer than control group(P<0.05).Meanwhile the length of LAA ridge,the lengths of superior border of the LAA ridge and the minimum distances from LAA to left circumflex artery were shorter than control group(P<0.05).Conclusion: There are obvious difference on types of LAA ridge between atrial fibrillation patients and control gourp.In atrial fibrillation group,there are most of LAA ridge between LSPV and LIPV.What's more,the minimum distances from LAA to left circumflex artery of atrial fibrillation patients was shorter.The research might provide science guidance to treat patients with atrial fibrillation by radiofrequency ablation therapy and percutaneous occlusion,and also had better clinic value to discuss the preoperative assessment.Part three Assessment of the volume and function of left atial ppendage by cardiac CTA in patients with atrial fibrillationObjective: The aim of this study was to evaluate variations in volume and function of left atial appendage(LAA)in with and patients without atrial fibrillation(AF)by 256 slice spiral cardiac CTA,which could preliminarily provide the clinical value for left atrial appendage occlusion and radiofrequency ablation in atrial fibrillation patients.Metholds: In the population of patients referred to our hospital for conventional 256 slice spiral CT coronary angiography,there were 40 AF patients(28 males and 12 females;mean age 49.10±10.17 years)in experimental group,and 40 patients without AF(22 males and 18 females;mean age 49.85±9.42 years)in control group,who were without heart valve disease,coronary heart disease and other cardiovascular diseases.Using the special cardiac function measurement for the original image,ten phases were reconstructed of the cardiac cycle(5%-95% with an interval of 10%).All phases were reviewed to observe the variations in LAA volume in the cardiac cycle,and to measure the maximum and minimum volume of LAA(LAAVmax and LAAVmin),the left atrial appendage ejection volume(LAAEV),and the left atrial appendage ejection fraction(LAAEF)were measured and analyzed statistically.Results:1.Compared with the general clinical data included gender,age,BMI between experimental group and control group,there was no statistical difference between the two groups(P>0.05).2.The LAAmax?LAAmin?LAmax?LAmin in experimental group had significantly larger than control group(P<0.05),but no statistical difference of LAAEV was observed between the two groups(P>0.05).3.The volume in experimental group had no regularity,and had a smaller range of change.Conclusion : The volume and function of left atrial appendage could be observed objectively by multislice spiral CT cardiac imaging.There are enlargement of left atrial appendage in patients with atrial fibrillation,and the LAAEF of atrial fibrillation patients was lower than non-atrial fibrillation patients.The research might provide science guidance to treat patients with atrial fibrillation by radiofrequency ablation therapy and percutaneous occlusion,and also had better clinic value to discuss the preoperative assessment. |
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