基于FT-CMR的心脏功能评估参数对心房颤动冷冻球囊消融患者治疗后复发的预测效能分析  

Predictive efficacy of FT-CMR-based cardiac function assessment parameters for recurrence of atrial fibrillation after cryoballoon ablation

作　　者：于颖慧 李晓刚[1] 李小伟 张璐[1] 何健 YU Ying-hui;LI Xiao-gang;LI Xiao-wei;ZHANG Lu;HE Jian(Cardiovascular Medicine Second Ward,the First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China;不详)

机构地区：[1]秦皇岛市第一医院心血管内科二病区,河北秦皇岛066000 [2]秦皇岛市第一医院心血管外科,河北秦皇岛066000

出　　处：《广东医学》2023年第2期235-239,共5页Guangdong Medical Journal

基　　金：秦皇岛市科学技术研究与发展计划(202101A117)。

摘　　要：目的探讨分析基于心脏磁共振特征追踪技术(FT-CMR)的心脏功能评估参数对心房颤动冷冻球囊消融患者治疗后复发的预测效能。方法选取2019年6月至2020年12月收治的126例预行冷冻球囊消融术的心房颤动患者为研究对象,术前均进行心脏磁共振检查,根据术后6个月内患者有无复发将其分为窦性心律组72例和房颤复发组54例。比较两组患者左心房应变及应变率参数,采用FT-CMR评估患者心脏功能,并进行单因素、多因素logistic回归分析,探讨FT-CMR心脏功能评估参数对心房颤动冷冻球囊消融术后复发的预测价值。结果房颤复发组患者女性、高血压、糖尿病、非阵发性心房颤动比例显著高于窦性心律组(P<0.05)。房颤复发组患者左心房总应变(Es)、左心房正向应变率峰值(SRs)、左心房被动应变(Ee)、心室舒张早期负向应变率峰值(SRe)、左心房整体纵向应变(PLAS)参数值低于窦性心律组(P<0.05)。Logistic多因素回归分析结果显示,性别(OR=3.511,95%CI:1.036~11.906)、PLAS(OR=1.089,95%CI:1.039~1.141)是心房颤动冷冻球囊消融患者治疗后复发的独立危险因素(P<0.05)。FT-CMR的心脏功能评估参数PLAS截断值为12时,预测心房颤动冷冻球囊消融患者治疗后复发的受试者工作特征(ROC)曲线下面积为0.82(95%CI:1.237~3.149),此时的敏感度和特异度分别为83.26%、78.45%。结论基于FT-CMR的心脏功能评估参数对心房颤动冷冻球囊消融患者治疗后复发具有较好预测价值,左心房整体纵向应变降低对预测心房颤动术后复发具有重要参考价值。Objective To analyze the predictive efficacy of cardiac magnetic resonance feature tracking(FT-CMR)-based cardiac function assessment parameters for recurrence of atrial fibrillation after cryoballoon ablation.Methods A total of 126 patients with atrial fibrillation who underwent cryoballoon ablation from June 2019 to December 2020 were selected.Cardiac magnetic resonance examination was performed before operation.Patients were divided into sinus rhythm group(n=72)and recurrence group(n=54)according to the recurrence of atrial fibrillation.The left atrial strain and strain rate parameters of the two groups were compared,and FT-CMR was used to evaluate the cardiac function of the patients.Predictive value of cardiac function assessment parameters of CMR for postoperative recurrence of atrial fibrillation after cryoballoon ablation was analyzed.Results The proportions of gender,hypertension,diabetes and non-paroxysmal atrial fibrillation in the recurrence group were significantly higher than those in the sinus rhythm group(P<0.05).The parameter values of Es,SRs,Ee,SRe,and PLAS in the recurrence group were significantly lower than those in the sinus rhythm group(P<0.05).Logistic multivariate regression analysis showed that gender(OR=3.511,95%CI:1.036-11.906)and PLAS(OR=1.089,95%CI:1.039-1.141)were independent risk factors associated with recurrence after cryoballoon ablation(P<0.05).When the PLAS cut-off value of the cardiac function assessment parameter of FT-CMR was 12,the area under the ROC curve for predicting the recurrence of atrial fibrillation after cryoballoon ablation was 0.82(95%CI:1.237-3.149)with sensitivity of 83.26%and specificity of 78.45%.Conclusion Cardiac function assessment parameters based on FT-CMR have good predictive value for the recurrence of atrial fibrillation after cryoballoon ablation,and the overall longitudinal strain reduction of the left atrium has an important reference value for predicting postoperative recurrence of atrial fibrillation.

关 键 词：心脏磁共振特征追踪技术 心脏功能 心房颤动 冷冻球囊消融术 术后复发 预测价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]