左心瓣膜术后心房颤动与三尖瓣反流的关系

The relationship between tricuspid regurgitation and atrial fibrillation after left-sided valve surgery

目的:研究左心瓣膜术后三尖瓣反流与术后心房颤动(房颤)的关系。方法:随访2002年3月至2008年11月接受主动脉瓣置换术或二尖瓣置换术,且未行三尖瓣成形术或三尖瓣置换术的患者374例,其中男性151例,女性223例,年龄23～79岁,平均(52±11)岁。所有患者均经过术前和术后彩色多普勒超声心动检查及心电图检查。单因素分析组间使用χ2检验。危险因素采用Logistic回归模型分析。结果:左心瓣膜术后房颤是术后发生三尖瓣反流的独立危险因素。Logistic多因素分析结果为:术后房颤、女性及术后左心房扩大,是术后三尖瓣反流的独立危险因素;术时年龄、术后左心室大小、术后右心室大小及术后射血分数这4项不是三尖瓣反流的危险因素。结论:左心瓣膜术后房颤是术后发生三尖瓣反流的独立危险因素。对于术后房颤应该引起重视,积极治疗。

Objective：To investigate if atrial fibrillation（AF） is an independent risk factor for tricuspid regurgitation（TR） after left-sided heart valve surgery.Methods：374 cases were followed-up from March 2002 to November 2008 with aortic valve replacement or mitral valve replacement without tricuspid repaire or tricuspid valve replacement 151 male,223 female,23-79years old,mean age of（52±11） years.All patients underwent preoperative and postoperative color Doppler echocardiography and electrocardiogram（ECG）.Univariate analysis between groups using the χ2 test.Using logistic regression model for risk factors analysis.Results： Postoperative AF is an independent risk factor for TR.Logistic multivariate analysis results reveal that： Postoperative AF,female gender,left atrial enlargement were independent risk factors for TR;age,size of left ventricular and right ventricular,ejection fraction of left ventricular after surgery were not risk factors for TR.Conclusion： AF after Left-sided heart valve surgery is an independent risk factor for TR.So it is important to notice that,postoperative AF should be treated actively.