左心房容积与冠状动脉旁路移植术后心房颤动相关性的研究  

Association between left atrial volume and atrial fibrillation followingcoronary artery bypass grafting surgery

作　　者：周自强[1] 吴明营[1] 杨青苗[2] 崔华楠[1] 

机构地区：[1]首都医科大学附属北京同仁医院心血管中心心外科,100176 [2]首都医科大学附属北京同仁医院心血管中心心内科,100176

出　　处：《心肺血管病杂志》2015年第2期106-109,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的：评价冠状动脉旁路移植术（CABG）前,二维超声心动图估测左心房容积指数（LAVI）与术后心房颤动发生的相关性。方法：入选北京同仁医院2010年1月至2012年6月期间,入院实施CABG术的冠心病患者106例进行前瞻性分析。将患者分为术后心房颤动组和术后未发生心房颤动组。采用多因素Logistic回归分析,评价术前通过二维超声心动图估测的LAVI值与术后心心房颤动动发生的相关性。结果：CABG术后发生心房颤动患者19例,术后心房颤动发生率为17.9%。术后心房颤动组的LAVI值显著高于术后未发生心房颤动组[（22.1±4.1）vs.（18.1±5.1）m L/m2,P=0.018]。多元logistic回归分析显示,年龄（OR=1.015,95%CI：1.017~1.0323,P=0.026）、高血压病史（OR=1.053,95%CI：1.019~1.087,P=0.009）、既往心房颤动病史（OR=2.273,95%CI：1.207~3.340,P=0.010）、LAV值（OR=1.784,95%CI：1.181~2.487,P=0.003）是CABG后心房颤动发生的独立危险因素。结论：CABG术前通过二维超声心动图估测的LAVI值是冠心病患者CABG术后心房颤动发生的独立危险因素,对于预测CABG术后心房颤动发生并进行危险分层具有一定参考价值。Objective：Objectives：To investigate the association between left atrial volume index （LA- VI） measured by echocardiography and atrial fibrillation following coronary artery bypass grafting （CABG）. Methods：From January 2010 to June 2012, one hundred and six patients with coronary artery disease undergoing CABG were prospectively enrolled in Beijing Tongren Hospital. The day before CABG, a complete echocar- diographic evaluation was performed with left atrial volume measurements. The primary endpoint of the study was postoperative atrial fibrillation （POAF） lasting 〉 30 seconds. Patients were divided into two groups based upon the AF occurrence after CABG. Results ： POAF was observed in 19 patients （ 17.9% ）. The LAVI was significantly higher in the POAF patients （n = 19） than in the normal rhythm group[ （22. 1 ±4. 1 ） vs. （18. 1 ± 5.1 ） mL/m2 , P = 0. 018 ]. Based on multivariate analyses, age （ OR = 1. 015, 95% CI： 1. 017 - 1. 0323, P = 0. 026） , history of hypertension OR = 1. 053, 95% CI： 1. 019 - 1. 087, P = 0. 009） , history of AF（ OR = 2. 273, 95% CI： 1. 207 - 3. 340, P = 0. 010）, and LAVI （ OR = 1. 784, 95 % CI： 1.181 - 2. 487, P = 0. 003 ） were found to be independent predictors of POAF. Conclusion： LAV measured by preoperative eehocardiographic evaluation may be a strong and independent predictor of occurrence of POAF, and would be a meaningful indicator for risk stratification of POAF in patients undergoing CABG.

关 键 词：冠状动脉旁路移植术 左心房容积 心心房颤动动 

分 类 号：R54[医药卫生—心血管疾病]