| Objective: To explore the correlation between TCM syndrome elements,diastolic function parameters and left atrial appendage thrombosis in patients with atrial fibrillation by collecting TCM syndrome elements and evaluating their diastolic function parameters and left atrial appendage thrombosis with echocardiography.Hoping to provide clinical references in both traditional Chinese medicine and Western medicine for thromboembolism risk assessment and anticoagulation treatment.Methods: A total of 74 atrial fibrillation patients were collected from November 2021 to January 2023 in our hospital.To determine the TCM syndrome elements of the patients according to the four diagnostic information of TCM on the first day of admission,recorded the general baseline data and relevant laboratory test data of the two groups of patients,and evaluated the parameters of cardiac diastolic function and left atrial appendage thrombosis by using transthoracic/transesophageal echocardiography.According to the results,the patients with atrial fibrillation were divided into non-thrombosis group and thrombus group,and the differences of their TCM syndrome elements and diastolic function parameters were analyzed;the correlation with left atrial appendage thrombosis were also analyzed;To explore the diagnostic effect of diastolic function index on left atrial appendage thrombosis.Results:1.In 74 patients with atrial fibrillation,the distribution frequency of syndrome elements of TCM disease location from high to low is as follows:heart 70 cases(94.6%),spleen 60 cases(81.1%),lung 35 cases(47.3%),kidney 21 cases(28.4%),liver 10 cases(13.5%);The distribution frequency of syndrome elements of nature of TCM disease from high to low is: Qi deficiency in 66 cases(89.2%),blood stasis in 37 cases(50.0%),phlegm turbidity in 42 cases(56.8%),Yang deficiency in 44 cases(59.5%),Yin deficiency in 27 cases(36.5%),blood deficiency in 27 cases(36.5%),dampness in 19 cases(25.7%),excessive fluid in 14 cases(18.9%),and Qi stagnation in 9 cases(12.2%).2.In the non-thrombotic group,the distribution frequency of syndrome elements of TCM disease location from high to low is as follows:heart 51 cases(94.4%),spleen 43 cases(79.6%),lung 21 cases(38.9%),kidney 10 cases(18.5%),liver 7 cases(13.0%);The distribution frequency of syndrome elements of nature of TCM disease from high to low is: Qi deficiency in 48 cases(88.9%),Yang deficiency in 36 cases(66.7%),phlegm turbidity in 31 cases(57.4%),blood deficiency in 23 cases(42.6%),blood stasis in 21 cases(38.9%),Yin deficiency in 15 cases(27.8%),dampness in 13 cases(24.1%),Qi stagnation in 7 cases(13.0%),and excessive fluid in 6 cases(11.1%).In the thrombotic group,the distribution frequency of syndrome elements of TCM disease location from high to low is as follows: heart 19 cases(95.0%),spleen 17 cases(85.0%),lung 14 cases(70.0%),kidney 11 cases(55.0%),liver 3 cases(15.0%);The distribution frequency of syndrome elements of nature of TCM disease from high to low is: Qi deficiency in 18 cases(90.0%),blood stasis in 16 cases(80.0%),Yin deficiency in 12 cases(60.0%),phlegm turbidity in 11 cases(55.0%),Yang deficiency in 8 cases(40.0%),excessive fluid in 8 cases(40.0%),dampness in 6 cases(30.0%),blood deficiency in4 cases(20.0%),and Qi stagnation in 2 cases。3.The proportion of "lung" and "kidney" in the patients with left atrial appendage thrombosis of atrial fibrillation is larger than that in the nonthrombotic group,and the proportion of "blood stasis","yin deficiency" and " excessive fluid " in the disease syndrome is larger than that in the non-thrombotic group(P<0.05).In addition,there was a correlation between left atrial appendage thrombosis and the syndrome elements of TCM disease location "lung","kidney",the syndrome elements of nature of TCM disease "blood stasis","yin deficiency",and "excessive fluid"(P<0.05).4.Compared with the laboratory test indexes of the non-thrombotic group and the thrombotic group,the proportion of patients with the plasma D-dimer level in the thrombotic group were higher than those in the nonthrombotic group(P<0.05).5.In the two groups of patients’ cardiac diastolic function parameters,the lateral E/e’ value,average E/e’ value,LAVI,and LAAev were statistically significantly different(P<0.05).Based on binary logistic regression analysis,the average E/e ’value and LAVI are independent risk factors for left atrial appendage thrombosis.6.The area under the ROC curve of the average E/e ’diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation was 0.779,the diagnostic sensitivity was 65.0% and the specificity was 87.0% when the cut value was 15.955;The area under the ROC curve for LAVI diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation was 0.797,the sensitivity was 90.0% and the specificity was50.3% when the cut value was 44.59.Conclusion:1.The syndrome elements of TCM disease location of patients with atrial fibrillation are mainly in “heart” and “spleen”,and the nature of TCM disease of them is mainly Qi deficiency;In patients with left atrial appendage thrombosis,the TCM disease location syndrome elements are mostly related to the combination of "lung" and "kidney",and the disease nature syndrome elements are mostly related to the combination of "blood stasis","yin deficiency" and " excessive fluid".2.In patients with atrial fibrillation,the average E/e’ratio and LAVI are independent risk factors for left atrial appendage thrombosis. |
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