心房颤动患者二尖瓣环钙化与射频消融术后复发的研究  

Mitral annular calcification and recurrence after radiofrequency ablation in patients with atrial fibrillation

作　　者：李冰 薛佳 蒋晨曦[1] 王伟[1] 汤日波[1] 龙德勇[1] 董建增[1] 姚艳[1] LI Bing;XUE Jia;LIANG Chenxi;WANG Wei;TANG Ribo;LONG Deyong;DONG Jianzeng;YAO Yan(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

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,100029

出　　处：《心肺血管病杂志》2023年第10期983-987,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(82070332、82370315);北京市教委重点项目(KZ202110025033)。

摘　　要：目的:观察心房颤动患者二尖瓣环钙化(mitral annular calcification,MAC)情况,并探讨MAC与射频消融术后复发的关系。方法:本研究纳入2019年1月1日至2020年12月31日,于北京安贞医院心内科住院行心房颤动射频消融术的患者785例,根据术前超声心动图分为MAC组和无MAC组。其中MAC组102例,无MAC组683例。平均随访16个月,观察两组患者心房颤动复发情况。使用Kaplan–Meier生存分析计算心房颤动射频消融术后复发率。结果:在行射频消融的心房颤动患者中,MAC组患者年龄更大,女性占69%,既往高血压、糖尿病的患病率更高,LAD更大,中重度二尖瓣反流的发生率更高,CHA2DS2-VASc评分更高,存在MAC的患者心房颤动射频消融术后复发率高于无MAC的患者(36%vs.22%,P=0.002)。Kaplan–Meier生存曲线显示,与无MAC的心房颤动患者相比,存在MAC的患者射频消融术后复发率更高。结论:心房颤动患者存在MAC与射频消融术后复发显著相关。Objective:To observe the mitral annular calcification(MAC)in patients with atrial fibrillation and then investigate the relationship between MAC and recurrence after radiofrequency ablation.Methods:This study included 785 patients who were hospitalized for radiofrequency ablation of atrial fibrillation at the Department of Cardiology,Beijing Anzhen hospital from 2019.1.1 to 2020.12.31,and were divided into MAC group and no MAC group according to preoperative echocardiography.There were 102 cases in the MAC group and 683 cases in the no MAC group.The mean follow-up was 16 months to observe the recurrence of atrial fibrillation in both groups.The recurrence rate after radiofrequency ablation of atrial fibrillation was calculated by Kaplan-Meier survival analysis.Results:Among patients with atrial fibrillation undergoing radiofrequency ablation,patients in the MAC group were older,69%of which were female,had a higher prevalence of previous hypertension and diabetes mellitus,a larger LAD,a higher incidence of moderate to severe mitral regurgitation,and a higher CHA2DS2-VASc score.Besides,there is a higher recurrence rate after radiofrequency ablation of atrial fibrillation in patients with MAC than in those without MAC(36%vs.22%,P=0.002).Kaplan-Meier survival curves showed a higher recurrence rate after radiofrequency ablation in patients with MAC compared with patients with atrial fibrillation without MAC.Conclusions:The presence of MAC in patients with atrial fibrillation is significantly associated with recurrence after radiofrequency ablation.

关 键 词：心房颤动 射频消融 二尖瓣环钙化 复发 

分 类 号：R54[医药卫生—心血管疾病]