摘要
目的探讨导管消融对射血分数保留的心力衰竭(heart failure with preserved ejection fraction,HFpEF)合并心房颤动患者的心脏结构及功能的影响。方法以2015年1月至2019年2月在安徽医科大学第二附属医院心内科住院的HFpEF合并心房颤动的患者100例为研究对象,按照治疗方法的不同分为导管消融组和药物治疗组,每组50例。随访6个月,观察两组治疗前后临床疗效、心脏结构及心功能、脑钠肽(BNP)水平的变化及不良事件发生情况。结果导管消融组随访6个月维持窦性心律者明显高于药物治疗组(78%vs. 22%,P <0.05)。导管消融组在临床疗效、心脏结构及功能[左室舒张末内径(LVEDD),左房内径(LAD),左室射血分数(LVEF),二尖瓣舒张早期血流峰值和二尖瓣瓣环运动速度之比(E/e′)]、BNP水平方面较药物治疗组均明显改善(P <0.05),导管消融组心衰再住院率减少,但差异无统计学意义(P> 0.05),脑卒中发生率两组患者差异无统计学意义(P> 0.05)。结论导管消融对HFpEF合并心房颤动患者较常规药物治疗能明显改善心功能,提高患者生存质量,可能减少心衰再住院率。
Objective We aimed to evaluate the effect of catheter ablation on cardiac structure and func-tion in patients with atrial fibrillation and heart failure with preserved ejection fraction(HFp EF).MethodsOnehundred patients admitted to the Second Affiliated Hospital of Anhui Medical University from January 2015 toFebruary 2019 were enrolled and divided into two groups(drug treatment group and catheter ablation group)dependingon different treatment approaches,50 cases in each group. After follow-up for six months,compared the clinicalefficacy,cardiac structure and function,the level of BNP and the adverse events between the two groups.Results The rate of sinus rhythm in catheter ablation group was significant higher than that in drug treatment group(78%vs. 22%,P < 0.05)after six months follow-up. After treatment,the clinical efficacy,the cardiac structure andfunction,including left ventricular end diastolic diameter(LVEDD),left atrial diameter(LAD),left ventricularejection fraction(LVEF)and the ratio of the peak velocity of early diastolic systolic blood flow and the peak veloci-ty of mitral annulus early dilation(E/e′),and the level of BNP were improved significantly in catheter ablationgroup compared with those in drug treatment group(P < 0.05). The rate of heart failure readmission was lower incatheter ablation group,however,the difference was not statistically significant(P > 0.05). The two groups hadsimilar stoke events rate(P > 0.05).ConclusionCatheter ablation improves the cardiac function and quality oflife in atrial fibrillation patients complicated with HFp EF,and might reduce the rate of heart failure readmission.
作者
张艳梅
许邦龙
王晓晨
ZHANG Yanmei;XU Banglong;WANG Xiaochen(Department of Cardiology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第14期1968-1971,共4页
The Journal of Practical Medicine
基金
安徽医科大学校科研基金项目(编号:2018xkj027)。
关键词
心房颤动
导管消融
射血分数保留的心力衰竭
心功能
心衰再住院率
atrial fibrillation
catheter ablation
heart failure with preserved ejection fraction(HFpEF)
cardiac function
rate of heart failure readmission
