超声心动图参数对射频导管消融术后心房颤动复发的评估价值分析

Assessment of the value of echocardiographic parameters in evaluating the recurrence of atrial fibrillation after radiofrequency catheter ablation

目的分析超声心动图参数对心房颤动(下称房颤)患者射频导管消融(下称消融)术后房颤复发的评估价值。方法回顾性分析2014年8月至2019年8月在余姚市中医医院住院行房颤消融术的非瓣膜性房颤患者92例,分为房颤复发组50例和房颤未复发组42例。收集患者的一般资料,包括性别、年龄、身高、体重、吸烟史、饮酒史、血压及既往病史,行超声心动图检查收集左心房前后径(LAD)、舒张早期室间隔二尖瓣环速度(e’)、舒张早期二尖瓣血流与室间隔二尖瓣环速度比值(E/e’)、左心室射血分数(LVEF)、左心耳流速,采用logistic回归分析复发危险因素。结果房颤复发组血管类疾病比例均高于房颤未复发组,差异有统计学意义(P<0.05)。房颤复发组的LAD、e’和E/e’高于房颤未复发组,LVEF和左心耳流速低于房颤未复发组,差异均有统计学意义(均P<0.05)。LAD、E/e’、LVEF和左心耳流速均是房颤患者的独立危险因素(均P<0.05)。结论超声心动图参数对房颤消融术后复发具有良好的评估价值,其中LAD、E/e’、LVEF和左心耳流速是房颤消融术后复发的独立危险因素。

Objective To analyze the value of echocardiographic parameters in evaluating the recurrence of atrial fibrillation(AF)after radiofrequency catheter ablation(hereinafter referred to as ablation).Methods This is a retrospective analysis of 92 patients with nonvalvular atrial fibrillation who underwent ablation in Yuyao Hospital of Traditional Chinese Medicine from August 2014 to August 2019.Fifty patients were in the group of AF recurrence and forty-two patients were in the non-recurrence group.We collected the patient's basic clinical characteristics,including gender,age,height,weight,smoking history,drinking history,blood pressure,and previous medical history,and collect the left atrial anteroposterior diameter(LAD),early diastolic mitral annulus velocity(e’),ratio of the peak early mitral inflow velocity over the early diastolic mitral annular velocity(E/e’),left ventricular ejection fraction(LVEF)and left atrial appendage flow velocity,and analyze risk factors for recurrence with logistic regression model.Results The proportion of vascular diseases in the AF recurrence group was higher than that in the AF non-recurrence group,and the difference was statistically significant(P<0.05).The LAD,e’,and E/e’of the AF recurrence group were significantly higher than those of AF non-recurrence group(P<0.05),and the LVEF and left atrial appendage flow velocity of AF recurrence group were significantly lower than those of the AF non-recurrence group(P<0.05).The LAD,E/e’,LVEF and left atrial appendage flow velocity were all independent risk factors in patients with AF(P<0.05).Conclusion Echocardiographic parameters have a good evaluation value for recurrence after AF ablation,among which,the LAD,E/e’,LVEF and left atrial appendage flow velocity are independent risk factors.