左心室舒张功能对射频消融术后心房颤动复发的影响  

Influence of left ventricular diastolic function on the recurrance of atrial fibrillation after radiofrequency catheter ablation

作　　者：刘彤[1] 刘心遥[2] 张建强[3] 董建增[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所心内科,北京100029 [2]北京同仁医院心血管中心,北京100041 [3]北京航天中心医院心脏疾病诊疗中心,北京100049

出　　处：《中华实用诊断与治疗杂志》2015年第5期438-440,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：首都临床特色应用研究基金(Z121107001012068)

摘　　要：目的探讨左心室舒张功能评估射频消融术后心房颤动复发的价值。方法首次行射频消融治疗孤立性心房颤动患者47例,根据左心室舒张功能分为舒张功能正常组33例和舒张功能不全组14例,随访观察2组射频消融术后心房颤动复发情况。结果随访6个月,3例失访,28例维持窦性心律（无复发组）,16例心房颤动复发（复发组）,其中舒张功能不全组复发率85.7%（12/14）,舒张功能正常组复发率12.1%（4/33）,差异有统计学意义（P〈0.05）;术后6个月复发组左心房前后径指数[（24.60±2.50）mm/m2]、左心房容积指数[（37.22±11.47）mL/m2]、二尖瓣血流频谱E峰速度[（94.25±19.19）cm/s]、术前E/e（10.75±4.29）、肺静脉D峰速度[（66.20±17.05）cm/s]高于无复发组[（23.20±2.10）mm/m2、（31.82±8.43）mL/m2、（80.98±14.48）cm/s、7.84±1.79、（45.46±6.28）cm/s]（P均〈0.05）;复发组术前左室射血分数[（53.97±8.27）%]低于无复发组[（58.62±7.54）%]（P〈0.05）;logistic多因素分析显示,术前E/e是射频消融术后心房颤动复发的独立危险因素（OR=1.145,95%CI：1.03~1.29,P=0.045）。结论心房颤动患者射频消融术前舒张功能状态与术后6个月心房颤动复发有关。Objective To explore the value of left ventricular diastolic function（LVDF）to predicting the recurrence of atrial fibrillation（AF）after radiofrequency catheter ablation.Methods Forty-seven patients initially undergoing catheter ablation for isolated AF were divided into normal LVDF group（n=33）and abnormal LVDF group（n=14）,and were compared the recurrence rates of AF after ablation between two groups.Results Six-month follow-up survey revealed 16 patients of AF recurrence（recurrence group）,including 12 patients of abnormal LVDF（85.7%）,and 4patients of normal LVDF（12.1%）（P0.05）.Twenty-eight patients maintained sinus rhythm（non-recurrence group）.And 3patients were lost follow-up.After 6-month follow-up,left atrial anterioposterior diameter index was（24.60±2.50）mm/m2,left atrial volume index was（37.22±11.47）mL/m2,peak E velocity was（94.25±19.19）cm/s,preoperative E/e＇was 10.75±4.29 and pulmonary vein D peak velocity was（66.20±17.05）cm/s in recurrence group,higher than those in non-recurrence group（（23.20±2.10）mm/m2,（31.82±8.43）mL/m2,（80.98±14.48）cm/s,7.84±1.79,（45.46±6.28）cm/s）（P0.05）.Left ventricular ejection fraction was lower in recurrence group（（53.97±8.27）%）than that in non-recurrent group（（58.62±7.54）%）（P0.05）.Logistic regression analysis revealed E/e＇was the independent risk factor of recurrence（OR=1.145,95%CI：1.03 to 1.29,P=0.045）.Conclusion LVDF before ablation in AF patients is correlated with the recurrence of AF 6months after ablation.

关 键 词：心房颤动 左心室舒张功能不全 超声心动图 导管射频消融 

分 类 号：R541.75[医药卫生—心血管疾病]