基于CT扫描的左心房结构参数与心房颤动患者射频消融术后1年内复发的关系研究  

Relationship between Left Atrial Structural Parameters Based on CT Scan and Recurrence within 1 Year after Radiofrequency Ablation in Patients with Atrial Fibrillation

作　　者：沈金链 宋娟[1] 王睿 严鹏勇[2] 罗章源 SHEN Jinlian;SONG Juan;WANG Rui;YAN Pengyong;LUO Zhangyuan(Department of Emergency,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China;Department of Cardiology,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China;Enshi Medical Technology(Shanghai)Co.,Ltd,Shanghai 201112,China)

机构地区：[1]上海中医药大学附属普陀医院急诊科,上海市200062 [2]上海中医药大学附属普陀医院心内科,上海市200062 [3]恩识医疗科技(上海)有限公司,上海市201112

出　　处：《实用心脑肺血管病杂志》2024年第6期26-29,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：上海市科研计划项目(19441915000)。

摘　　要：目的探究基于CT扫描的左心房结构参数与心房颤动(AF)患者射频消融术(RFA)后1年内复发的关系。方法选取2020年8月—2022年8月在上海中医药大学附属普陀医院急诊科接受RFA的AF患者196例为研究对象,根据患者RFA后1年内有无复发将其分为复发组(n=51)和未复发组(n=145)。收集患者的一般资料及术前基于CT扫描的左心房结构参数、实验室检查指标。采用多因素Logistic回归分析、ROC曲线探讨基于CT扫描的左心房结构参数与AF患者RFA后1年内复发的关系。结果复发组持续性AF占比高于未复发组,左心房左外侧脊(LLR)长度、左心房直径(LAD)长于未复发组,左心房容积指数(LAVI)高于未复发组,左心耳体积大于未复发组(P<0.05)。多因素Logistic回归分析结果显示,左心房LLR长度、LAVI、左心耳体积是AF患者RFA后1年内复发的独立影响因素(P<0.05)。ROC曲线分析结果显示,左心房LLR长度、LAVI、左心耳体积预测AF患者RFA后1年内复发的AUC分别为0.901〔95%CI(0.855~0.947)〕、0.897〔95%CI(0.855~0.940)〕、0.972〔95%CI(0.945~0.999)〕。结论左心房LLR长度、LAVI、左心耳体积是AF患者RFA后1年内复发的影响因素,且三者对AF患者RFA后1年内复发具有较高/中等的预测价值。Objective To explore the relationship between left atrial structural parameters based on CT scan and recurrence within 1 year after radiofrequency ablation(RFA)in patients with atrial fibrillation(AF).Methods A total of 196 patients with AF who underwent RFA in the Department of Emergency,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2020 to August 2022 were selected as the research objects.According to the recurrence within 1 year after RFA,the patients were divided into recurrence group(n=51)and non-recurrence group(n=145).The general data,preoperative left atrial structural parameters based on CT scan and laboratory examination indexes of the patients were collected.Multivariate Logistic regression analysis and ROC curve were used to explore the relationship between left atrial structural parameters based on CT scan and recurrence within 1 year after RFA in patients with AF.Results The proportion of persistent AF in the recurrence group was higher than that in the non-recurrence group,the left atrial left lateral ridge(LLR)length and left atrial diameter(LAD)were longer than those in the non-recurrence group,the left atrial volume index(LAVI)was higher than that in the non-recurrence group,and the left atrial appendage volume was larger than that in the non-recurrence group(P<0.05).Multivariate Logistic regression analysis showed that left atrial LLR length,LAVI and left atrial appendage volume were independent influencing factors of recurrence within 1 year after RFA in patients with AF(P<0.05).ROC curve analysis showed that the AUC of left atrial LLR length,LAVI and left atrial appendage volume in predicting recurrence within 1 year after RFA in patients with AF were 0.901[95%CI(0.855-0.947)],0.897[95%CI(0.855-0.940)]and 0.972[95%CI(0.945-0.999)],respectively.Conclusion The length of left atrial LLR,LAVI and left atrial appendage volume are the influencing factors of recurrence within 1 year after RFA in patients with AF,and the three have a high/medium predicti

关 键 词：心房颤动 射频消融术 左心房 复发 

分 类 号：R541.75[医药卫生—心血管疾病]