摘要
目的探讨持续性房颤射频消融术后使用沙库巴曲缬沙坦对患者心房颤动(房颤)复发、心脏结构及心功能的影响.方法入选180例行房颤射频消融术的持续性房颤患者,术前随机分为试验组(90例)和对照组(90例).对照组按照房颤指南给予常规围术期药物治疗,试验组在对照组基础上加用沙库巴曲缬沙坦.两组在术后3、6和12个月进行随访,观察患者的血压、N-末端B型利钠肽前体(NT-proBNP)、P波离散度、左房前后径、左房容积指数、二尖瓣返流面积、左室收缩末容积指数、左室舒张末容积指数、左心室射血分数.结果试验组较对照组血压下降(P<0.05),但未出现低血压及相关症状.随访3、6和12个月试验组患者窦性心律维持率为80.0%、78.9%和75.6%,高于对照组的72.2%、70.0%和68.9%(χ^(2)=4.866、6.667和4.091,P=0.027、0.010和0.043).6个月及12个月随访时NT-proBNP、P波离散度、左房前后径、左房容积指数、二尖瓣返流面积、左室收缩末容积指数、左室舒张末容积指数试验组均较对照组减少(均P<0.05),试验组左室射血分数较对照组提高(P<0.05).结论持续性房颤导管消融术后使用沙库巴曲缬沙坦在维持窦性心律、逆转心脏重构、纠正心功能方面有满意疗效.
Objective To investigate the efeets of Sacubitril/Valsartan on the recurrence of atrial fibillation(AF).cardiac strueture and function after catheter ablation(CA)of persistent AF.Methods A total of 180 patients with persistent AF were randomly divided into the treatment group(n=90)and the control group(n=90)before undergoing CA.The control group was given routine perioperative medication according to the guidelines for AF management,and the treatment group was additionally given Sacubitril/Valsartan.Blood presure.N-terminal pro-B-type natriuretic peptide(NT-proBNP),P-wave dispersion.left atrial dimension.left atrial volume index.mitral regurgitation area,left ventricular end-systolic volume index.end-diastolic volume index and left ventricular ejection fraction(L.VEF)were measured at 3.6 and 12 months after the procedure.Results Blood pressure was lower in the treatment group than in the control group(P<0.05),but no hypotension or related symptoms oecurred.The sinus rhythm maintenance rate was higher in the treatment group than in the control group at 3.6 and 12 months during the follow-up(80.0%.72.2%,78.9%us.70.0%.75.6%,68.9%.χ^(2)=4.866.6.667 and 4.091,P=0.027.0.010 and 0.043.respectively).At 6 and 12 months during the follow up,NT proBNP.P wave dispersion.left atrial diameter.left atrial volume index.mitral regurgitation area.left ventricular end-systolice volume index and end-diastolic volume index were lower(all P<0.05)and LVEF was higher(P<0.05)in the treatment group than in the control group.Conclusions In patients with persistent AF after CA.Sacubitril/Valsartan has favorable effects in maintaining sinus rhythm.reversing cardiac remodeling and improving cardiac function.
作者
黄琼
刘荣
陈立鸿
袁义强
Huang Qiong;Liu Rong;Chen Lihong;Yuan Yiqiang(Department of Cardiovascular Diseases,Henan Provincial Chest Hospital,Zhengzhou 450000.China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2021年第7期872-876,共5页
Chinese Journal of Geriatrics
关键词
心房颤动
导管消融
沙库巴曲缬沙坦
Atrial fibillation
Catheter ablation
Sacubitril/valsartan
