血清醛固酮水平对持续性心房颤动患者首次导管消融术后复发的预测价值

The predictive value of serum aldosterone level for postoperative recurrence of persistent atrial fibrillation after first catheter ablation

目的探讨血清醛固酮水平对持续性心房颤动患者首次导管消融术后复发的预测价值。方法连续选取2018-10~2019-09于阜阳市人民医院首次接受导管消融治疗的持续性房颤患者51例。房颤复发的定义为消融3个月后发生持续时间≥30 s的房颤、房扑、房速。术后随访1年,根据随访结果分为复发组与未复发组,分析相关因素在房颤复发中的预测价值。结果术后1年共19例(37.3%)患者复发。多因素logistic回归分析结果表明,持续性房颤患者术前血清醛固酮水平是消融术后复发的独立预测因素(OR=1.037,95%CI:1.011~1.064,P=0.005)。ROC曲线结果显示,醛固酮水平预测导管消融术后房颤复发的曲线下面积为0.752(95%CI:0.611~0.862,P<0.001),术前血清醛固酮水平诊断复发的最佳截断值为136.43 ng/dl。结论持续性房颤导管消融患者术前的血清醛固酮水平与术后复发密切相关,可作为预测房颤复发的指标。

Objective To investigate the predictive value of serum aldosterone level for postoperative recurrence of persistent atrial fibrillation(AF)after first catheter ablation.Methods A total of 51 AF patients undergoing first catheter ablation were continuously chosen from Fuyang People′s Hospital during October 2018 and September 2019.The recurrence of AF was defined as AF,atrial flutter,and atrial tachycardia with duration≥30 s after catheter ablation for 3 months.The patients were followed up for 1 year after the operation.According to the follow-up results,the patients were divided into recurrence group and non-recurrence group,and the predictive value of related factors in recurrence of AF was analyzed.Results One year after the operation,19 cases(37.3%)relapsed.The results of multivariate logistic regression analysis showed that preoperative serum aldosterone level in the patients with persistent AF was an independent predictive factor of AF recurrence after catheter ablation(OR=1.037,95%CI:1.011~1.064,P=0.005).The results of receiver operating characteristic(ROC)curve showed that the area under curve(AUC)of aldosterone level for predicting AF recurrence after catheter ablation was 0.752(95%CI:0.611~0.862,P<0.001),and the optimal cut-off value of preoperative serum aldosterone level to predict postoperative recurrence was 136.43 ng/dl.Conclusion The level of serum aldosterone in patients with persistent AF undergoing catheter ablation is closely related to postoperative recurrence,which can be used as an indicator to predict the recurrence of AF.