超声心动图检测左心房及左心耳功能对长程持续性心房颤动患者射频消融术后复发的预测价值  

Echocardiographic examination of left atrium and left atrial appendage function for predicting recurrence after radiofrequency ablation in patients with long-standing persistent atrial fibrillation

作　　者：陈锋[1] 潘杰[2] 陈园园[1] Chen Feng;Pan Jie;Chen Yuanyuan(Department of Cardiovascular Medicine,Lishui People's Hospital,Lishui 323000,China;Department of General Practice,Lishui People's Hospital,Lishui 323000,China)

机构地区：[1]浙江省丽水市人民医院心血管内科,323000 [2]浙江省丽水市人民医院全科医学科,323000

出　　处：《心脑血管病防治》2025年第2期32-35,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨超声心动图检测左心房及左心耳功能对长程持续性心房颤动患者射频消融术后复发的预测价值。方法回顾性分析2019年2月至2022年1月在丽水市人民医院121例长程持续性心房颤动患者的临床资料。所有患者心房颤动消融术后18个月行超声检查,进行左心房和左心耳测量。随访18个月,根据是否复发分为两组,复发组(25例)与未复发组(96例),比较两组左心耳、左心房功能指标[左心耳最大容积(LAAVmax)、左心耳最小容积(LAAVmin)、左心房最大容积(LAVmax)、左心房最小容积(LAVmin)、左心耳排空分数(LAAEF)、左心耳排血量(LAAeV)、左心房排空分数(LAEF)、左心房排血量(LAEV)]。ROC曲线分析各项指标对术后复发的预测效能。结果相比于未复发组,复发组LAAVmax、LAAVmin、LAVmax、LAVmin均升高(t=2.298、3.669、4.186、4.381,P<0.05),LAAeV、LAAEF、LAEF、LAEV均降低(t=4.671、5.337、5.611、2.046,P<0.05)。Logistic回归分析和Cox回归分析均显示LAAVmin、LAVmax、LAVmin、LAAeV、LAAEF、LAEF、LAEV是患者术后复发的影响因素(P<0.05)。ROC曲线分析显示超声心动图8项指标联合预测复发的AUC为0.910,敏感度为100.0%,特异度为80.2%。结论左心房、左心耳功能指标可预测长程持续性心房颤动患者射频消融术后复发情况。Objective To explore the predictive value of echocardiographic examination of left atrium and left atrial appendage function in the recurrence of patients with long-standing persistent atrial fibrillation(AF)after radiofrequency ablation(RFA).Methods A retrospective analysis was conducted on the clinical data of 121 patients with long-standing persistent AF treated at Lishui People's Hospital from February 2019 to January 2022.All patients underwent echocardiographic examination 18 month after AF ablation,and measurements of the left atrium and left atrial appendage were performed.Follow-up was conducted for 18 months,and patients were divided into two groups based on recurrence:the recurrence group(25 cases)and the non-recurrence group(96 cases).Comparisons were made between the two groups for left atrial appendage and left atrial functional parameters[left atrial appendage maximum volume(LAAVmax),left atrial appendage minimum volume(LAAVmin),left atrial maximum volume(LAVmax),left atrial minimum volume(LAVmin),left atrial appendage ejection fraction(LAAEF),left atrial appendage ejected volume(LAAeV),left atrial ejection fraction(LAEF),left atrial ejection volume(LAEV)],and the predictive efficacy of each parameter for postoperative recurrence was analyzed using ROC curve analysis.Results Compared with the non-recurrent group,the recurrence group had increased LAAVmax,LAAVmin,LAVmax,and LAVmin(t=2.298,3.669,4.186,4.381;P<0.05),and decreased LAAeV,LAAEF,LAEF,and LAEV(t=4.671,5.337,5.611,2.046;P<0.05).Logistic regression analysis and Cox regression analysis showed that LAAVmin,LAVmax,LAVmin,LAAeV,LAAEF,LAEF and LAEV were influencing factors for postoperative recurrence(P<0.05).The ROC curve analysis showed that the combined prediction of recurrence by eight echocardiographic parameters had an AUC of 0.910,with a sensitivity of 100.0%and a specificity of 80.2%.Conclusion Left atrium and left atrial appendage functional parameters can predict the recurrence of patients with long-standing persistent AF after RFA.

关 键 词：左心房 左心耳功能 心房颤动 射频消融术 

分 类 号：R54[医药卫生—心血管疾病]