血清sST2联合左心房前后径对心房颤动射频消融术后复发的预测价值

Prediction of atrial fibrillation recurrence after radiofrequency ablation with serum sST2 combined with left atrium anteroposterior diameter

目的探讨术前血清sST2浓度以及sST2联合左心房前后径(LAD)对心房颤动(房颤)射频消融术后复发的预测价值。方法选取2020年2月至2020年10月间在西安交通大学第二附属医院心内科住院并且进行射频消融手术治疗的房颤患者84例,其中阵发性房颤57例,持续性房颤27例,男性48人,女性36人,平均年龄(64.24±10.17)岁。收集所有患者术前一般临床资料和血液学指标。采用ELISA法检测患者血清sST2浓度。心脏超声于收缩末期胸骨旁长轴切面测量LAD。所有入选的房颤患者于消融术后3、6、12月定期随访。采用单因素和多因素Cox回归分析sST2联合LAD对房颤术后复发的预测价值。结果单因素及多因素Cox回归模型分析显示,血清sST2(HR=1.014,95%CI 0.986~1.035,P=0.035)、LAD(HR=1.271,95%CI 0.946~1.378,P=0.036)是影响房颤复发的独立危险因素。sST2联合LAD预测房颤复发的能力进一步提升,ROC曲线下面积为0.907,灵敏度0.846,特异度0.894。结论术前检测血清sST2浓度以及sST2联合超声测量LAD可对房颤射频消融术后复发提供预测价值。

Objective To explore the predictive value of sST2 combined with LAD for the recurrence of AF patients after radio frequency ablation.Method From February 2020 to October 2020,87 patients with atrial fibrillation who were hospitalized in the cardiology department of our hospital and underwent radiofrequency ablation were included in the study.84 patients were finally included in the study.Including 57 patients with paroxysmal atrial fibrillation and 27 patients with persistent atrial fibrillation,48 males and 36 females,with an average age of(64.24±10.17)years.The general clinical data and hematological indexes of all patients were collected.The concentration of serum sST2 was detected by double antibody sandwich ELISA.M-mode echocardiography was used to measure the anteroposterior diameter of the left atrium in the long axis parasternal view at the end of systole,the distance between the posterior wall of the aorta and the intima of the posterior wall of the atrium was measured.All the selected patients were followed up regularly in 3,6 and 12 months after ablation.Single factor and multiple factor Cox regression analysis was used to predict the recurrence of atrial fibrillation.Results Through single factor and multi factor Cox regression model,it is suggested that serum sST2(HR=1.014,95%CI 0.986~1.035,P=0.035)and LAD(HR=1.271,95%CI 0.946~1.378,P=0.036)were the independent factors influencing the recurrence of AF.The ability of sST2 combined with LAD to predict recurrence of AF was further improved,the area under ROC curve of combined factor was 0.907.Conclusion The detection of serum sST2 concentration before operation could predict the recurrence of AF after RFA;serum sST2 combined with LAD could further improve the predictive valueo of the recurrence of AF after RFA.