左心耳排空速度对非瓣膜性心房颤动患者射频导管消融术后晚期复发的预测意义  

The Prognostic Significance of Left Atrial Appendage Emptying Velocity in Predicting Late Recurrence After Radi of requency Catheter Ablation in Patients with Nonvalvular Atrial Fibrillation

作　　者：胡艳敏 刘赛哲 朱慎慎 刘阳 吴照科[1] HU Yanmin;LIU Saizhe;ZHU Shenshen;LIU Yang;WU Zhaoke(Geriatric Medicine Department of The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan,China;Cardiovascular Medicine Department of The First Medical Center of Chinese PLA General Hospital,Beijing 100039,China;Cardiovascular Medicine Department of The 989th Central Hospital of PLA,Luoyang 471000,Henan,China)

机构地区：[1]郑州大学第二附属医院老年医学科,河南郑州450014 [2]中国人民解放军总医院第一医学中心心血管内科,北京100039 [3]中国人民解放军联勤保障部队第九八九医院心血管内科,河南洛阳471000

出　　处：《心血管病学进展》2024年第12期1127-1132,共6页Advances in Cardiovascular Diseases

摘　　要：目的探讨左心耳排空速度(LAAEV)对非瓣膜性心房颤动(NVAF)患者射频导管消融(RFCA)术后晚期复发的临床预测价值。方法回顾性分析2020年1月—2023年5月在中国人民解放军总医院第一医学中心心血管内科入院并首次行RFCA的217例NVAF患者的临床资料,通过术后门诊复查、再次入院、电话等方式随访术后复发情况。根据RFCA术后3个月之后是否复发,将研究对象分成复发组(64例)和未复发组(153例)。统计两组患者一般资料并进行组间比较,将差异有统计学意义的因素纳入单因素和多因素logistic回归模型进一步分析,得出LAAEV是否为NVAF患者RFCA术后晚期复发的独立危险因素的结论,并根据ROC曲线及曲线下面积(AUC)分析该因素对RFCA术后晚期复发的预测价值。结果复发组在持续性房颤、病程、N末端脑钠肽前体、早期复发方面均高于未复发组,而LAAEV比未复发组低,差异有统计学意义(P<0.05),logistic回归分析可见LAAEV与NVAF患者RFCA术后晚期复发独立相关(P<0.05),ROC曲线显示AUC为0.661,截断值为0.348,灵敏度为68.8%,特异度为66.0%。结论LAAEV是NVAF患者RFCA术后晚期复发的一个独立危险因素,且具有较显著的预测价值。Objective To investigate the clinical predictive value of left atrial appendage emptying velocity(LAAEV)for late recurrence in patients with nonvalvular atrial fibrillation(NVAF)undergoing radiofrequency catheter ablation(RFCA).Methods Retrospective analysis of the clinical data of 217 patients with NVAF who presented to the Cardiovascular Medicine Department of The First Medical Center of Chinese PLA General Hospital from January 2020 to May 2023 and underwent RFCA for the first time.The recurrence of NVAF after RFCA was followed up by outpatient review,re-hospitalization,and telephone call.According to whether recurred after 3 months,the subjects were divided into a recurrence group(64 cases)and a non-recurrence group(153 cases).The general data of the two groups of patients were counted and compared between the two groups.The factors with statistically significant differences were included in the univariate and multivariate logistic regression models for further analysis to conclude whether LAAEV was an independent risk factor for late recurrence after RFCA in NVAF patients,and the predictive value of LAAEV in late recurrence after RFCA was analyzed according to ROC curve and AUC value.Results The levels of persistent atrial fibrillation,duration of disease,N-terminal pro-brain natriuretic peptide and early recurrence in the recurrent group were higher than those in the non-recurrent group,while LAAEV was lower than that in the non-recurrent group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that LAAEV was independently associated with late recurrence after RFCA in patients with NVAF(P<0.05).The ROC curve shows that the AUC is 0.661,the cutoff is 0.348,the sensitivity is 68.8%,and the specificity is 66.0%.Conclusion LAAEV is an independent risk factor for late recurrence after RFCA in NVAF patients,with significant predictive value.

关 键 词：非瓣膜性心房颤动 射频导管消融 左心耳排空速度 晚期复发 

分 类 号：R541.75[医药卫生—心血管疾病]