左心房重构对房颤进展的影响

The effect of left atrial remodeling on the progression of atrial fibrillation

目的:研究阵发性房颤与持续性房颤患者左心房大小及功能的差异。方法:收集拟行射频消融术的43例房颤患者的心脏MSCT资料,包括持续性房颤15例,阵发性房颤28例,比较两组患者左心房容积指数、左心房射血分数的差异。结果:与阵发性房颤组相比,持续性房颤组左心房最小容积指数(left atrial minimum volume index,LAVImin)增大,左心房射血分数(left atrial ejection fraction,LAEF)减少,差异有统计学意义(P<0.05)。两组患者的左心房最大容积指数(left atrial maximum volume index,LAVImax)无统计学差异。房颤患者LAEF与LAVImin呈负相关。LAVImin是房颤进展的独立预测因素(P=0.003,OR=1.082,95%可信区间:1.028~1.139)。结论:左心房重构加重是阵发性房颤进展为持续性房颤的推动力,并且与左心房射血分数下降密切相关。

Objective To study the difference of left atrial size and function between paroxysmal atrial fibrillation and persistent atrial fibrillation.Methods The multislice spiral CT findings of 43 patients with AF,Including 28 patients with paroxysmal AF and 15 patients with persistent AF,were analyzed retrospectively.The differences of left atrial volume index(LAVI)and left atrial ejection fraction(LAEF)between the two groups were compared.Results Compared with the paroxysmal AF group,the LAVImin increased and the LAEF decreased in the persistent AF group,while there was no statistically significant difference in the LAVImax between the two groups.The LAEF was negatively correlated with LAVImin in patients with atrial fibrillation.LAVImin is an independent predictor of atrial fibrillation progression.Conclusions The aggravation of left atrial remodeling is the driving force for the progression of paroxysmal atrial fibrillation to persistent atrial fibrillation,and is closely related to the decrease of left atrial ejection fraction.