摘要
目的探讨经食管超声心动图评价左心耳功能在房颤导管射频消融术(radiofrequency catheter ablation,RFCA)后复发监测中的作用。方法采用回顾性分析的方法,选取中国科学技术大学附属第一医院2016年6月—2019年10月确诊房颤并首次行房颤导管射频消融手术的患者84例,根据随访结果分为房颤消融术后复发组(19例)和未复发组(65例)。收集患者临床资料,并采用经食管超声心动图测量左心耳功能相关参数。比较房颤复发与未复发2组患者各指标的变化并明确其中的危险因素。结果房颤RFCA术后复发组左房前后径、左心耳口径及深度大于未复发组(均P<0.01),而左心耳面积变化率、排空速度、充盈速度复发组小于未复发组(均P<0.01)。左心耳面积变化率与复发时间(r=0.685,P=0.001)、排空速度(r=0.562,P=0.012)、充盈速度(r=0.627,P=0.004)之间存在正相关关系,与BNP(r=-0.558,P=0.013)及心耳深度(r=-0.496,P=0.031)呈负相关。左心耳面积变化率预测房颤RFCA术后复发的AUC为0.933(0.875~0.991),左心耳面积变化率减小是RFCA术后复发的独立预测因子,左心耳面积变化率<40.95%作为预测房颤射频消融术后复发的临界值效果最佳。结论经食管超声心动图评价左心耳功能对房颤导管消融术后复发有预测价值。其中左心耳面积变化率减小是RFCA术后复发的独立预测因子。
Objective To investigate the role of transesophageal echocardiography(TEE)in evaluating the left atrial appendage(LAA)function in monitoring recurrence of atrial fibrillation(AF)in patients after radiofrequency catheter ablation(RFCA).Methods A total of 84 patients in the First Affiliated Hospital of University of Science and Technology of China diagnosed with AF and undergoing RFCA for the first time were retrospectively collected from June 2016 to October 2019.After follow-up,patients were divided into the relapse group(n=19)and non-relapse group(n=65)accordingly.The clinical data of patients were collected,and TEE was used to measure relevant parameters of LAA function.In addition,the various indexes of patients between the relapse group and non-relapse group were followed-up and compared,aiming to identify risk factors.Results The diameter of left atrial antero-Posterior,the diameter and depth of the LAA in the relapse group were greater than those in the non-relapse group(all P<0.01),while the area change rate,emptying rate and filling rate were smaller in the relapse group than those in the non-relapse group(all P<0.01).The area change rate is positively related to reciprocal time(r=0.685,P=0.001),emptying rate(r=0.562,P=0.012),filling rate(r=0.627,P=0.004)and is negatively related to BNP(r=-0.558,P=0.013),depth of the LAA(r=-0.496,P=0.031).In addition,the area change rate predicted the AUC of relapse after RFCA is 0.933(0.875-0.991).The area change rate was an independent predictive factor for relapse after RFCA,and area change rate<40.95%as the cutoff value could generate the optimal predictive performance of relapse after RFCA.Conclusion Evaluation of LAA functions via TEE is of predictive value for relapse after RFCA.Moreover,the decreased area change rate is an independent predictive factor for relapse after RFCA.
作者
王玉婷
苏浩
杨好意
黄向阳
杨冬妹
高礼福
WANG Yu-ting;SU Hao;YANG Hao-yi;HUANG Xiang-yang;YANG Dong-mei;GAO Li-fu(Department of Echocardiogram,the First Affiliated Hospital of USTC(Anhui Provincial Hospital),Hefei,Anhui 230001,China;不详)
出处
《中华全科医学》
2020年第9期1547-1550,共4页
Chinese Journal of General Practice
基金
中国科大附一院(安徽省立医院)高层次人才科研基金项目(RC2020004)
2018年度安徽省学术和技术带头人后备人选科研活动经费资助项目(2018H176)。
关键词
导管射频消融
房颤
复发
经食管超声心动图
左心耳
Radiofrequency catheter ablation
Atrial fibrillation
Recurrence
Transesophageal echocardiography
Left atrial appendage
