阵发性心房颤动患者术前功能性二尖瓣反流程度与射频消融术后复发的相关性  

Correlation between preoperative functional mitral regurgitation degree and recurrence after radiofrequency ablation in patients with paroxysmal atrial fibrillation

作　　者：强超华 王跃涛[3] 杨珍妮 刘飞[1] 杨玲[2] 徐敏[1] QIANG Chaohua;WANG Yuetao;YANG Zhenni;LIU Fei;YANG Ling;XU Min(Echocardiography Room,Changzhou First People’s Hospital of Soochow University,Jiangsu 213003,China)

机构地区：[1]苏州大学附属常州市第一人民医院心超室,江苏省常州市213003 [2]苏州大学附属常州市第一人民医院心内科,江苏省常州市213003 [3]苏州大学附属常州市第一人民医院核医学科,江苏省常州市213003

出　　处：《临床超声医学杂志》2021年第11期806-810,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(82070405);国家自然科学青年基金项目(81701734);常州市科技局应用基础研究及科技支撑计划(CJ20190086、CE20195044);常州市卫计委指导项目(WZ201804)。

摘　　要：目的探讨阵发性心房颤动(以下简称房颤)患者术前功能性二尖瓣反流程度与射频消融术后复发的相关性。方法选取在我院首次行射频消融术治疗的阵发性房颤患者274例,术前无二尖瓣反流172例,轻度反流72例,中度反流21例,重度反流9例,比较不同程度二尖瓣反流患者临床特征、术前常规超声心动图参数和二尖瓣功能参数的差异。应用单因素及多因素Logistic回归分析术前功能性二尖瓣反流程度与射频消融术后复发的相关性。结果术前不同程度的功能性二尖瓣反流患者在脑卒中史、左房内径(LAD)、左房容积(LAV)、左室舒张末内径、左室射血分数、消融术后复发率方面比较,差异均有统计学意义(均P<0.05)。术后3个月随访动态心电图,其中房颤复发者23例,未复发者251例。单因素Logistic回归分析显示,术前功能性轻、中、重度二尖瓣反流和LAD是房颤射频消融术后复发的独立影响因素(OR=5.121、34.667、112.667、1.102,均P<0.05);在未调整、初步调整及充分调整协变量后显示,随着二尖瓣反流程度的加重,相应增加了房颤射频消融术后复发风险(均P<0.05)。结论术前功能性二尖瓣反流程度是房颤射频消融术后复发的危险因素,术后复发风险随着二尖瓣反流程度的加重而增加,提示其可能是预测房颤射频消融术后复发的影响因子。Objective To investigate the correlation between preoperative functional mitral regurgitation and recurrent of atrial fibrillation after radiofrequency ablation in patients with paroxysmal atrial fibrillation.Methods A total of 274 patients with atrial fibrillation who underwent radiofrequency ablation for the first time in our hospital were selected.There were 172 patients without mitral regurgitation before radiofrequency surgery,72 patients with mild regurgitation,21 patients with moderate regurgitation,and 9 patients with severe mitral regurgitation before radiofrequency.Clinical characteristics,preoperative echocardiographic parameters and mitral functional parameters of patients with different degrees of mitral regurgitation were compare.Univariate and multivariate Logistic regression were used to analyze the correlation between preoperative functional mitral regurgitation and recurrence after radiofrequency ablation.Results There were statistically significant differences in the history of stroke,left atrial diameter(LAD),left atrial volume(LAV),left ventricular end-diastolic diameter,left ventricular ejection fraction and recurrence rate after ablation in patients with functional mitral regurgitation of different degrees before surgery(all P<0.05).At 3 months follow-up,23 patients had recurrent atrial fibrillation and 251 did not.Univariate Logistic regression analysis showed that preoperative functional mild,moderate and severe mitral regurgitation and LAD were independent factors for recurrence of atrial fibrillation after radiofrequency ablation(OR=5.121,34.667,112.667,1.102,all P<0.05).After unadjusted,preliminary adjusted,and fully adjusted covariates,the risk of atrial fibrillation recurrence after radiofrequency ablation was increased with the severity of mitral regurgitation(all P<0.05).Conclusion The degree of functional mitral regurgitation before surgery is a risk factor for recurrence of atrial fibrillation after radiofrequency ablation,and the risk of postoperative recurrence is increase with

关 键 词：超声心动描记术 二尖瓣反流 射频消融术 心房颤动 复发 相关性 

分 类 号：R540.45[医药卫生—心血管疾病] R541.75[医药卫生—内科学]