摘要
目的观察阵发性心房颤动(PAF)患者经导管射频消融术后左心房结构功能变化,以及术后复发的危险因素。方法选取2018年1月—2021年1月我院行经导管射频消融术治疗的非瓣膜性PAF 65例作为观察组,并选取同期健康人群40例作为对照组。收集2组一般资料,并在窦性心律下收集比较左心房二维及三维结构及功能性指标。术后随访6个月,评价术后复发及未复发患者左心房结构及功能性指标变化,并分析术后复发的危险因素。结果观察组术前与对照组左心房前后径(LAD1)、左心房上下径(LAD2)、左心房左右径、左心房最大容积(LAV max)、左心房最小容积(LAV min)、左心房排空分数(LAEF)、左心房容积指数(LAVI)、左心房储存期纵向应变(LASr)、左心房导管期纵向应变、左心房收缩期纵向应变(LASc)比较差异有统计学意义(P<0.05,P<0.01)。术后6个月,未复发亚组LAD1、LAD2、LAV max、LAV min、LAEF、LAVI、LASr、LASc均较术前显著改善(P<0.05,P<0.01);复发亚组LASc降低(P<0.05),余指标比较差异无统计学意义(P>0.05)。复发与未复发亚组术前LAD1、LAV max、LAV min、LAEF、LAVI、LASr及LASc比较差异有统计学意义(P<0.05,P<0.01)。多因素Logistic回归分析显示,LAVI为PAF患者经导管射频消融术后6个月复发的独立危险因素(P=0.016)。结论经导管射频消融术有利于逆转PAF患者左心房重构,可改善其左心房结构和功能;LAVI是PAF患者经导管射频消融术后复发的独立危险因素。
Objective To observe changes of left atrial structure and function and risk factors of recurrence in patients with paroxysmal atrial fibrillation(PAF)after transcatheter radiofrequency ablation(RFA).Methods A total of 65 patients with non-valvular PAF who had been treated by transcatheter RFA between January 2018 and January 2021 were selected as observation group,and other 40 healthy physical examinees at the same period were selected as control group.General data was collected,and the two-dimensional and three-dimensional structural and functional indexes of the left atrium were collected and compared under sinus rhythm in two groups.The patients were followed up for postoperative 6 months to evaluate changes of left atrial structure and functional indexes in patients with and without recurrence,and risk factors of recurrence were analyzed.Results There were significant differences in left atrial anteroposterior diameter(LAD1),left atrial superio-inferior diameter(LAD2),left-to-right diameter of left atrium,left atrial maximum volume(LAV max),left atrial minimum volume(LAV min),left atrial emptying fraction(LAEF),left atrial volume index(LAVI),left atrial longitudinal strain during reservoir phase(LASr),left atrial longitudinal strain during catheter phase and left atrial longitudinal strain during systolic phase(LASc)between in observation group before operation and in control group(P<0.05,P<0.01).After operation for 6 months,values of LAD1,LAD2,LAV max,LAV min,LAEF,LAVI,LASr and LASC were significantly improved compared with those before operation in non-recurrence subgroup(P<0.05,P<0.01);in recurrence subgroups,LASC value was significantly decreased(P<0.05),but there were no significant difference in the other indexes compared with those before operation(P>0.05).There were significant differences in LAD1,LAV max,LAV min,LAEF,LAVI,LASr and LASc before operation between recurrence and non-recurrence subgroups(P<0.05,P<0.01).Multivariate logistic regression analysis showed that LAVI was an independent risk factor for recurrence within 6 months in PAF patients after transcatheter RFA(P=0.016).Conclusion Transcatheter RFA is helpful to reverse left atrial reconstitution and improve left atrial structure and function in patients with PAF.LAVI is an independent risk factor for recurrence in patients with PAF after transcatheter RFA.
作者
韩蕊
梅迎晨
郑梅
陈游洲
赵兴山
HAN Rui;MEI Ying-chen;ZHENG Mei;CHEN You-zhou;ZHAO Xing-shan(Department of Cardiology,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《解放军医药杂志》
CAS
2021年第9期62-68,共7页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
国家青年科学基金项目(81700330)
北京市优秀人才青年个人项目(2016000021469G176)。
关键词
心房颤动
经导管射频消融术
心房功能
左
实时三维超声心动图
复发
影响因素分析
Atrial fibrillation
Transcatheter radiofrequency ablation
Atrial function,left
Real time three-dimensional echocardiography
Recurrence
Root cause analysis
