摘要
目的探讨左心房和左心耳功能对长程持续性心房颤动射频消融术后复发的预测价值。方法回顾性分析121例行射频消融术治疗长程持续性房颤患者的临床资料。统计术前左心房增强CT检测指标[左心房最大容积(LAVmax)、左心房最小容积(LAVmin)、左心耳最大容积(LAAVmax)、左心耳最小容积(LAAVmin)、左心房排血量(LAEV)、左心房排空分数(LAEF)、左心耳排血量(LAAEV)、左心耳排空分数(LAAEF)]。术后随访18个月统计复发情况,并根据复发情况分为复发组(25例)、未复发组(96例),比较两组左心耳、左心房功能,对术后复发影响因素进行二元Logistic回归分析和Cox回归模型分析,绘制受试者工作特征曲线分析各项指标的预测效能。结果复发组LAVmax、LAVmin、LAAVmax、LAAVmin均高于未复发组,LAEV、LAEF、LAAEV、LAAEF均低于未复发组,差异有统计学意义(P<0.05或0.01)。LAVmax、LAVmin、LAAVmax、LAAVmin、LAEV、LAEF、LAAEV、LAAEF是长程持续性房颤射频消融术后复发的影响因素。受试者工作特征曲线显示,八项指标联合预测术后复发的曲线下面积为0.952。结论长程持续性心房颤动患者术前左心房和左心耳体积及排血能力与射频消融术后复发存在关联性,术前评估左心房和左心耳的结构和功能对术后复发有较高预测价值。
Objective To explore the predictive value of left atrium and left atrial appendage function to the recurrence of long-term persistent atrial fibrillation(LTPAF)after radiofrequency ablation.Methods Clinical data of 121 LTPAF patients undergoing radiofrequency ablation were retrospectively analyzed.Pre-operative enhanced CT detection indicators(LAVmax,LAVmin,LAAVmax,LAAVmin,LAEV,LAEF,LAAEV,LAAEF)were counted.After radiofrequency ablation they were followed up for 18 months to count recurrence status and divided into recurrence(n=25)and non-recurrence(n=96)group according to recurrence status.The left atrial appendage and left atrium functions were compared between two groups,the factors of postoperative recurrence analyzed using binary logistic regression and Cox regression models,and the predictive efficacies of various indicators analyzed by drawing receiver operating characteristic(ROC)curve.Results LAVmax,LAVmin,LAAVmax and LAAVmin were all higher and LAEV,LAEF,LAAEV and LAAEF lower in recurrence than non-recurrence group,differences were statistically significant(P<0.05 or 0.01).LAVmax,LAVmin,LAAVmin,LAEV,LAEF,LAAEV and LAAEF were factors influencing the recurrence of the LTPAF after radiofrequency ablation.The ROC showed that the area under the curve of eight indexes combined to predict postoperative recurrence was 0.952.Conclusion The volume and blood output ability of the left atrium and left atrial appendage before radiofrequency ablation are related to postoperative recurrence in LTPAF patients,-preoperative evaluations of the structure and function of the left atrium and left atrial appendage are of higher value to predict postoperative recurrence.
作者
康锐
凌盈盈
王蒙
江莉
杨琪
陈珂
Kang Rui;Ling Yingying;Wang Meng;Jiang Li;Yang Qi;Chen Ke(First-author'address:Xinyang Central Hospital,Xinyang 464000,Henan,China)
出处
《临床心身疾病杂志》
CAS
2023年第5期35-39,56,共6页
Journal of Clinical Psychosomatic Diseases
基金
河南省卫生计划科研项目(编号LHGJ20200080)。
关键词
心房颤动
左心房功能
左心耳功能
射频消融术
预测价值
atrial fibrillation
left atrium function
left atrial appendage function
radiofrequency ablation
predictive value
