左心房心外膜脂肪组织体积及CT衰减值在房颤射频消融术后复发的预测价值  

Predictive Value of Left Atrial Epicardial Adipose Tissue Volume and CT Attenuation Values in Recurrence after Radiofrequency Ablation of Atrial Fibrillation

作　　者：杨新梅 景梦园 张宏瑜 郭钰 史佳丽 刘建莉[1] YANG Xin-mei;JING Meng-yuan;ZHANG Hong-yu;GUO Yu;SHI Jia-li;LIU Jian-li(Department of Radiology,The Second Hospital,Lanzhou University、Key Laboratory of Medical Imaging of Gansu Province、The Second Clinical Medical School,Lanzhou University、Gansu International Science and Technology Cooperation Base for Artificial Intelligence in Medical Imaging,Lanzhou 730030,Gansu Province,China)

机构地区：[1]兰州大学第二医院放射科、甘肃省医学影像重点实验室、兰州大学第二临床医学院、医学影像人工智能甘肃省国际科技合作基地,甘肃兰州730030

出　　处：《中国CT和MRI杂志》2025年第1期78-81,共4页Chinese Journal of CT and MRI

基　　金：甘肃省卫生行业科研计划优秀青年人才和骨干人才项目(GSWSQN2023-04);兰州大学第二医院“萃英研究生导师”培养计划项目(CYDSPY202003)。

摘　　要：目的探究左心房(LA)心外膜脂肪组织体积(EATV)及CT衰减值与心房颤动(AF)射频消融术后复发的关系。方法随访AF术前接受左房肺静脉CT血管造影(LAPV-CTA)的患者,随访终点是AF复发,随访时间是1年,最终纳入110例患者复发36例,未复发74例)。通过Siemens Synogo.Via测量总EATV、EAT CT衰减值、LA-EATV及LA-EAT CT衰减值,比较两组间的差异。结果36例(32.7%)出现复发,与AF未复发组相比,AF复发组持续性AF比例(13%)更高,合并冠心病比例更低(28%),T-EATV[(141.08±46.28)cm^(3)VS(96.44±34.93)cm^(3),P<0.05]与LA-EATV[(16.50±6.23)cm^(3)VS(9.82±4.52)cm^(3),P<0.05]更大,AF复发组LA-EAT CT衰减值[(-74.58±3.86)HU VS(-79.48±7.27)HU,P<0.05]更高。结论LAEATV、LA-EAT CT衰减值是AF射频消融术后复发的独立预测因子,LA-EATV与LA-EAT CT衰减值的联合模型预则AF复发的效能最高。Objective To investigate the relationship between left atrial(LA)epicardial adipose tissue volume(EATV)and CT attenuation values and recurrence after radiofrequency ablation of atrial fibrillation(AF).Methods Patients who underwent left atrial pulmonary vein CT angiography(LAPV-CTA)before AF procedure were followed up with the endpoint of AF recurrence for 1 year,and 110 patients were finally included(36 recurrences and 74 non-recurrences).Total EATV,EAT CT attenuation values,LA-EATV and LA-EAT CT attenuation values were measured by Siemens Synogo.Via to compare the differences between the two groups.Results Recurrence occurred in 36 cases(32.7%),with a higher proportion of persistent AF(13%)and a lower proportion of comorbid coronary artery disease(28%)in the AF recurrence group compared with the AF non-recurrence group,and a higher proportion of T-EATV[(141.08±46.28)cm^(3) VS(96.44±34.93)cm^(3),P<0.05]and LA-EATV[(16.50±6.23)cm^(3)VS(9.82±4.52)cm^(3),P<0.05]was greater,and LA-EAT CT attenuation value[(-74.58±3.86)HU VS(-79.48±7.27)HU,P<0.05]was higher in the AF recurrence group.Conclusion LA-EATV and LA-EAT CT attenuation values were independent predictors of recurrence after AF radiofrequency ablation,and the combined model of LA-EATV and LA-EAT CT attenuation values had the highest efficacy in predicting AF recurrence.

关 键 词：心房颤动 心外膜脂肪组织 射频消融术 体层摄影术 X线计算机 

分 类 号：R541.75[医药卫生—心血管疾病]