2016年ASE/EACVI指南评估的左室舒张功能对阵发性心房颤动术后复发的预测价值  

Predictive Value of Left Ventricular Diastolic Function Assessed by 2016 ASE/EACVI Guidelines for Postoperative Recurrence of Paroxysmal Atrial Fibrillation

作　　者：洪璐 曹明强[2] 周亚峰[2] HONG Lu;CAO Mingqiang;ZHOU Yafeng(Department of Cardiovascular Surgery,The First Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu,China;Department of Cardiology,The First Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu,China)

机构地区：[1]苏州大学附属第一医院心脏大血管外科,江苏苏州215000 [2]苏州大学附属第一医院心血管内科,江苏苏州215000

出　　处：《心血管病学进展》2021年第5期464-469,共6页Advances in Cardiovascular Diseases

基　　金：国家自然科学基金面上项目(81873486)。

摘　　要：目的评价阵发性心房颤动(房颤)患者行射频导管消融术的疗效,探讨2016年版舒张功能指南对阵发性房颤患者经射频导管消融术后晚期复发的影响。方法连续入选2016年1月—2017年12月在苏州大学附属第一医院行射频导管消融术的阵发性房颤患者211例。收集患者基线资料,使用2009年ASE/EAE指南及2016年ASE/EACVI指南分别评估左室舒张功能。术后3个月定义为空白期,术后至少随访12个月。根据随访结果将患者分为未复发组和复发组。结果经过平均27个月的随访,随访的患者中有55例复发。Kaplan-Meier生存分析显示无论哪一版指南评估的左室舒张功能,左室舒张功能不全均增加了阵发性房颤术后晚期复发的风险。在Cox比例风险模型分析中,发现2016年版指南评估的左室舒张功能不全和E峰减速时间是阵发性房颤患者经射频导管消融术后复发的独立危险因素。结论阵发性房颤患者射频导管消融术治疗后,2016年ASE/EACVI指南评估的左室舒张功能对术后复发有较高的预测价值。Objective The purpose of this study is to evaluate the efficacy of radiofrequency catheter ablation(RFCA)in patients with paroxysmal atrial fibrillation,and to evaluate the effect of left ventricular diastolic function evaluation under the guidance of the 2016 version guide on late recurrence after RFCA in patients with paroxysmal atrial fibrillation.Methods Retrospective data on 211 consecutive patients with paroxysmal atrial fibrillation who underwent RFCA in The First Affiliated Hospital of Soochow University from January 2016 to December 2017 were included.Patient baseline data were collected and left ventricular diastolic function was assessed using the 2009 ASE/EAE guidelines and the 2016 ASE/EACVI guidelines.The blank period was 3 months after operation.The patients were followed up at least 12 months after surgery.According to the follow-up results,the patients were divided into the non-recurrent group and the recurrent group.Results After a follow-up of an average of 27 months,55 patients had recurrent atrial fibrillation.Kaplan-Meier survival analysis showed that regardless of which version of the guideline evaluated left ventricular diastolic function,left ventricular diastolic dysfunction increased the risk of late recurrence after paroxysmal atrial fibrillation.In the Cox proportional hazard model analysis,left ventricular diastolic dysfunction assessed in the 2016 guideline and E-peak deceleration time were found to be independent risk factors for recurrence after transcatheter ablation in patients with paroxysmal atrial fibrillation.Conclusion After RFCA for paroxysmal atrial fibrillation,the left ventricular diastolic function assessed by the 2016 ASE/EACVI guidelines has a higher predictive value for postoperative recurrence.

关 键 词：左室舒张功能 阵发性心房颤动 心房颤动复发 射频导管消融术 

分 类 号：R541.75[医药卫生—心血管疾病]