局灶性房性心动过速导致心肌病的风险因素研究  

Rrisk factors of cardiomyopathy induced by focal atrial tachycardia

作　　者：张燕[1] 刘筱[1] 田晓芬 陶卉[1] 于杨[1] 吴群英 Yan Zhang;Xiao Liu;Xiao-fen Tian;Hui Tao;Yang Yu;Qun-ying Wu(Department of Cardiac Function,Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院心功能科,湖北武汉430014

出　　处：《中国现代医学杂志》2018年第17期89-93,共5页China Journal of Modern Medicine

基　　金：2015年度湖北省武汉市临床医学科研项目(No:WX15D64)

摘　　要：目的分析局灶性房性心动过速(ATs)导致心动过速性心肌病(TCM)的发病率、危险因素及结局。方法回顾性分析2007年3月-2015年3月在该院行心内电生理学检查并确诊为局灶性ATs的196例患者资料,其中17例患者确诊为TCM。结果 (1)在196例局灶性ATs中,TCM患者多见于年轻男性(P<0.05);且心动过速性质多为持续性(P<0.05);(2)TCM患者与局灶性ATs患者的心动过速周期、心率比较,差异无统计学意义(P>0.05);(3)在多变量分析中,年龄、持续性是TCM患者的独立危险因素,且年轻是TCM患者的显著特征;(4)(51±19)个月的随访中,16例TCM患者经射频消融术或严格的胺碘酮控制后,左心室射血分数均提高(P<0.05);1例TCM患者因擅自停用胺碘酮死于心力衰竭。结论局灶性ATs导致TCM的发病率为8.67%;年轻和持久性是TCM患者的独立危险因素;大部分TCM患者的预后良好。Objective To investigate the incidence, risk factors and outcome of tachycardia-induced cardiomyopathy（TCM） in patients with focal atrial tachycardia（AT）. Methods Formal reports for all patients undergoing electrophysiological studies from March 2007 to March 2015 were included, only 196 patients were diagnosed as focal AT. Of the 196 patients, 17 patients（8.67%） were identified to have TCM. Results The TCM patients were mostly young males（P〈0.05）. The TCM was more likely to be persistent（P〈0.05）. There was no significant difference in tachycardia cycle length or heart rate between the patients with TCM and those with focal AT（P〈0.05）. In a multivariable analysis, the younger age and persistent nature were the independent risk factors for TCM. Only the age was significantly different between the TCM patients and non-TCM patients（P〈0.05）. In a（51 ± 19）-month follow-up, 16 TCM patients had improved left ventricle ejection fraction after radiofrequency ablation or strict control with Amiodarone（P〈0.05）. However, 1 patient died of heart failure due to unauthorized withdrawal of Amiodarone. Conclusions The incidence of TCM is 8.67% in focal AT patients. Younger age and persistent nature are the independent risk factors for TCM. The prognosis of most TCM patients is good.

关 键 词：房性心动过速 心肌病 心动过速性心肌病 

分 类 号：R542.2[医药卫生—心血管疾病]