内脂素与射频消融术后心房颤动复发的相关性研究

Study on the correlation between visfatin and recurrence of atrial fibrillation after radiofrequency ablation

目的探讨血清内脂素与经导管射频消融术(RFCA)后心房颤动复发的相关性。方法纳入近五年来在我院接受RFCA的226例心房颤动患者,按照随访12个月内心房颤动是否复发,将其分为复发组(74例)和非复发组(152例),分析两组患者的一般临床资料、超声心动图指标和内脂素水平,采用logistic回归方程分析心房颤动复发的相关因素,并使用受试者工作特征(ROC)曲线评价内脂素预测心房颤动复发的价值。结果较非复发组,复发组年龄偏大,高血压和冠心病患者多,左房容积指数(LAVI)明显增高(均为P<0.05)。此外,复发组的血清内脂素水平明显高于非复发组(P<0.001)。多元logistic回归方程显示,内脂素(OR=1.165,95%CI:1.111~1.222)、年龄(OR=1.100,95%CI:1.037~1.167)、高血压(OR=3.122,95%CI:1.295~7.526)和LAVI(OR=1.066,95%CI:1.022~1.112)是心房颤动复发的独立危险因素。ROC曲线显示,内脂素预测RFCA后心房颤动复发的曲线下面积为0.809(95%CI:0.749~0.868,P<0.001)。结论高水平的血清内脂素与RFCA后心房颤动复发密切相关,可作为心房颤动复发危险分层的可靠指标。

Objective To investigate the correlation between serum visfatin and recurrence of atrial fibrillation(AF)after radiofrequency catheter ablation(RFCA).Methods A total of 226 patients with AF who received RFCA in our hospital in the past five years were enrolled.According to whether AF recurred within 12 months,patients were divided into the recurrent group(n=74)and non recurrent group(n=152).The general clinical data,echocardiographic indexes and the level of visfatin were analyzed.Logistic regression was used to analyze the related factors for AF recurrences.Receiver operating characteristic(ROC)curve was used to evaluate the value of visfatin in predicting the recurrence of AF.Results Compared with the non recurrent group,the recurrent group was older,more hypertension and coronary heart disease patients,and higher level of left atrial volume index(LAVI)and serum visfatin(all P<0.05).Multivariate logistic regression showed that visfatin(OR=1.165,95%CI:1.111-1.222),age(OR=1.100,95%CI:1.037-1.167),hypertension(OR=3.122,95%CI:1.295-7.526)and LAVI(OR=1.066,95%CI:1.022-1.112)were risk factors for AF recurrence,and ROC curve showed that visfatin could be used to predict AF recurrence,the area under the curve was 0.809(95%CI:0.749-0.868,P<0.001).Conclusions The high level of serum visfatin is closely related to the recurrence of AF after RFCA,and can be used as a reliable indicator for the risk stratification of AF recurrence.