左心功能参数对长程持续性房颤导管射频消融术后复发的预测价值研究  

Predictive value of left ventricular function parameters for recurrence after long-standing persistent atrial fibrillation catheter radiofrequency ablation surgery

作　　者：康锐 凌盈盈 夏楠 王蒙 谢秀乐 KANG Rui;LING Ying-ying;XIA Nan;WANG Meng;XIE Xiu-le(The Second Department of Cardiology,Xinyang Central Hospital,Xinyang,Henan 464000,China;Department of CT Diagnosis,Xinyang Central Hospital,Xinyang,Henan 464000,China;Department of Ultrasound Diagnosis,Xinyang Central Hospital,Xinyang,Henan 464000,China)

机构地区：[1]信阳市中心医院心血管内二科,河南信阳464000 [2]信阳市中心医院CT诊断科,河南信阳464000 [3]信阳市中心医院超声诊断科,河南信阳464000

出　　处：《医药论坛杂志》2024年第23期2503-2507,2513,共6页Journal of Medical Forum

摘　　要：目的探究左心功能参数对长程持续性房颤(long-standing persistent atrial fibrillation,LSP-AF)患者心脏导管射频消融术后复发的预测价值。方法选取2020年6月—2021年12月信阳市中心医院收治的120例LSP-AF患者为研究对象,均实行心脏导管射频消融术治疗。术后随访18个月,根据是否术后复发分为术后复发组和术后未复发组。在术前对患者的左心功能参数进行测量,比较两组患者的一般资料及术前左心房、左心耳和左心室功能参数,分析心脏导管射频消融术后复发的影响因素,并使用受试者工作特征(ROC)曲线评估左心功能参数对心脏导管射频消融术后复发的预测价值。结果单因素分析显示术后复发组在年龄、病程、左心房最大容积(LAV_(max))、左心房最小容积(LAV_(min)),左心房排空分数(LAEF)、左心耳最大容积(LAAV_(max))、左心耳最小容积(LAAV_(min))、左心耳排空分数(LAAEF)、组织多普勒二尖瓣环舒张早期运动速度(Em)及二尖瓣舒张早期血流充盈速度E/Em比值等方面与术后未复发组比较差异均具有统计学意义(P<0.05)。logistic回归分析结果显示,LAV_(max)、LAV_(min)、LAEF、LAAV_(max)、LAAV_(min)、LAAEF、Em及E/Em是影响LSP-AF患者术后复发的危险因素(P<0.05)。ROC曲线分析结果显示,LAV_(max)、LAV_(min)、LAEF、LAAV_(max)、LAAV_(min)、LAAEF、Em及E/Em预测LSP-AF患者术后复发的AUC值分别为0.715、0.734、0.837、0.759、0.742、0.815、0.807、0.812,灵敏度分别为79.68%、67.92%、77.74%、59.83%、73.67%、86.49%、78.88%、81.27%,特异度分别为70.96%、84.73%、87.71%、86.28%、75.68%、72.47%、81.36%、78.55%。其中,LAEF的AUC值大于其他参数的AUC值(P<0.05)。结论术前左心功能参数与LSP-AF患者心脏导管射频消融术后复发具有一定相关性,LAV_(max)、LAV_(min)、LAAV_(max)、LAAV_(min)及E/Em的升高及LAEF、LAAEF、Em的降低均会导致患者术后复发的风险上升。Objective To investigate the predictive value of left ventricular function parameters for recurrence after cardiac catheter ablation in patients with long-standing persistent atrial fibrillation(LSP-AF).Methods Totally 120 patients with LSP-AF admitted to Xinyang Central Hospital from June 2020 to December 2021 were selected as the study subjects,all of whom underwent cardiac catheter radio frequency catheter ablation treatment.All patients were followed up for 18 months,and were divided into postoperative recurrence group and postoperative non-recurrence group according to postoperative recurrence.The left ventricular function parameters of the patients were measured before surgery,and the general data and preoperative left atrial,left atrial,and left ventricular function parameters of the two groups were compared.The factors influencing recurrence after cardiac catheter radiofrequency ablation were analyzed,and the predictive value of left cardiac function parameters after cardiac catheter radiofrequency ablation was evaluated using receiver operating characteristics(ROC)curve.Results Univariate analysis showed that age,duration of disease,maximum left atrial volume(LAV_(max)),minimum left atrial volume(LAV_(min))in the postoperative recurrence group.Left atrial emptying fraction(LAEF),left auricular maximum volume(LAAV_(max)),left auricular minimum volume(LAAV_(min)),left auricular emptying fraction(LAAEF),tissue Doppler mitral ring early diastolic motion velocity(Em)and mitral valve early diastolic flow filling velocity E/Em ratio were compared with those in the group without postoperative recurrence.The differences were statistically significant(P<0.05).logistic regression analysis showed that LAV_(max),LAV_(min),LAEF,LAAV_(max),LAAV_(min),LAAEF,Em,E/Em were risk factors for postoperative recurrence in patients with LSP-AF(P<0.05).The results of Receiver operating characteristic analysis showed that the AUC values of LAV_(max),LAV_(min),LAEF,LAAV_(max),LAAV_(min),LAAEF,Em,E/Em for predicting postoperative re

关 键 词：心脏导管射频消融术 左心功能参数 长程持续性房颤 

分 类 号：R541[医药卫生—心血管疾病]