心外膜脂肪厚度与射频消融术后心房颤动复发的关系

Relation between epicardial fat thickness and recurrence of atrial fibrillation after radiofrequency ablation

目的探讨心外膜脂肪厚度(EFT)与射频消融术后心房颤动复发的关系。方法选择2016年1月至2018年4月南京市浦口区中医院收治的年龄> 18岁的持续性心房颤动并计划行射频消融治疗的患者220例。入选患者术前均进行常规超声心动图检查,并测量EFT。对患者进行6个月随访以观察射频消融术后的心房颤动复发情况。结果在6个月随访期间,共有66例(30. 0%)患者心房颤动复发,154例患者仍维持窦性心律,无患者出现血栓栓塞或出血性并发症。心房颤动组的EFT和左心室舒张末期内径(LVEDD)明显大于窦性心律组[(8. 3±1. 1) mm比(6. 2±1. 0) mm、(48±3) mm比(44±4) mm],差异均有统计学意义(均P <0. 01)。多因素Logistic回归分析结果显示,LVEDD(比值比=1. 332,95%置信区间:1. 011~1. 702,P=0. 032)和EFT(比值比=3. 011,95%置信区间:1. 023~8. 142,P <0. 001)为射频消融术后心房颤动复发的独立危险因素。结论 EFT可以作为心房颤动患者射频消融术后心房颤动复发有效的预测因子。

Objective To explore the relation between epicardial fat thickness( EFT) and recurrence of atrial fibrillation( AF) after radiofrequency ablation. Methods From January 2016 to April 2018,220 patients over18 years old diagnosed as persistent AF undergoing radiofrequency ablation were enrolled at Nanjing Pukou Hospital of Traditional Chinese Medicine. EFT was measured by transthoracic echocardiography. All patients were followed up for 6 months after ablation to observe the recurrence of AF. Results During 6-month follow-up,66 patients( 30. 0%) had AF recurrence and 154 patients represented sinus rhythm without thromboembolism or hemorrhagic complications. Patients with AF recurrence had higher EFT and left ventricular end-diastolic diameter( LVEDD) as compared with patients with sinus rhythm[( 8. 3 ± 1. 1) mm vs( 6. 2 ± 1. 0) mm,( 48 ± 3) mm vs( 44 ± 4) mm]( all P < 0. 01). Multiple logistic regression analysis showed that LVEDD( odds ratio = 1. 332,95% confidence interval: 1. 011-1. 702,P = 0. 032) and EFT( odds ratio = 3. 011,95% confidence interval:1. 023-8. 142,P < 0. 001) were independent risk factors of AF recurrence after radiofrequency ablation.Conclusion EFT can be used as a valuable predictor of AF recurrence after radiofrequency ablation.