左心房球形度与心房颤动患者血栓栓塞事件的相关性研究

The correlation between left atrial sphericity and thromboembolic events in patients with atrial fibrillation

目的研究左心房球形度(LASP)与心房颤动(房颤)患者血栓栓塞事件的相关性。方法连续收集2011年1月-2018年10月郑州大学第一附属医院心内科行射频消融手术的房颤患者,经过年龄与性别配对后,共纳入研究组(有房颤相关的血栓栓塞事件史患者)与对照组(无血栓栓塞事件的房颤患者)共157对患者。比较两组间LASP及其他相关指标的差异,并利用条件logistic回归分析其与血栓栓塞事件的相关性。绘制受试者工作特征(ROC)曲线分析LASP的诊断价值,并制定新的CHA2DS2-VASc-LASP2评分模式。结果(1)研究组LASP明显高于对照组[(87.5±7.1)%比(82.8±6.1)%,P=0.001],差异具有统计学意义。(2)条件logistic回归分析显示LASP(0R=1.10,95%CZ1.05-1.16,P=0.001)、左心房容积指数(0R=1.01,95%CI 1.00-1.02,P=0.016)和CHA2D-VASc评分(0R=1.77,95%C/1.30-2.41,P=0.001)与血栓栓塞事件呈独立正相关性。⑶ROC曲线分析显示,LASP[曲线下面积(AUC)=0.712,95%C/0.656-0.768,P=0.001]较左心房容积指数(AUC=0.650,95%C/0.589-0.710,P=0.001)和CHA2D-VASc评分(AUC=0.612,95%C/0.550-0.674,P=0.001)的AUC更大。(4)CHA2D-VASc-LASP2评分与血栓栓塞事件呈正相关(0R=1.95,95%C/1.55-2.42,P=0.001)。结论LASP与房颤患者血栓栓塞事件呈独立正相关。

Objective To study the correlation between left atrial sphericity(LASP)and thromboembolic events(TE)in patients with atrial fibrillation(AF).Methods This study was conducted in patients with AF underwent radiofrequency ablation in the Department of Cardiology of First Affiliated Hospital of Zhengzhou University from January 2011 to October 201&The AF patients with TE(study group,n=157)and the AF patients without TE(control group,n=157)were matched for age and gender.The differences of LASP and other related indexes between the two groups were compared,and the correlation between LASP and TE was analyzed by conditional logistic regression.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of LASP for TE.Results(1)The LASP in the study group was significantly higher than that in the control group[(87.5±7.1)%vs.(82.8±6.1)%,P=0.001].⑵Conditional logistic regression analyses showed that LASP(0R=1.10,95%CZ1.05-1.16,P=0.001),left atrial volume index(0R=1.01,95%CI 1.00-1.02,P=0.016)and CHA2D-VASc score(OR=1.77,95%C/1.30-2.41,P=0.001)were independently and positively correlated with TE.(3)The ROC curve analysis showed that the area under the curve(AUC)of left atrial sphericity(AUC=0.712,95%CI 0.656-0.768,P=0.001)was larger than the AUC of either left atrial volume index(AUC=0.650,95%C/0.589-0.710,P=0.001)or CHA2D-VASc score(AUC=0.612,95%C/0.550-0.674,P=0.001).(4)CHA2D-VASc-LASP2 score was positively correlated with TE(0R=1.95,95%C/1.55-2.42,P=0.001).Conclusion LASP is independently and positively correlated with TE in patients with AF.