BMI、LAD联合CHA_(2)DS_(2)-VASc评分与心房颤动患者射频导管消融术后复发的相关性研究

Correlation among BMI,LAD,CHA_(2)DS_(2)-VASc scores and recurrence in patients with atrial fibrillation after radiofrequency catheter ablation

目的探讨体质指数(BMI)、左房内径(LAD)联合CHA_(2)DS_(2)-VASc评分与心房颤动(房颤)患者射频导管消融术后复发的相关性。方法选取2018年9月至2019年9月于武汉大学人民医院心血管内科行射频消融的219例房颤患者,收集患者的临床资料并随访。根据随访结果将患者分为术后复发组(n=56)和未复发组(n=163),比较两组患者一般临床资料及辅助检查结果。结果复发组年龄、BMI、LAD、右房内径(RAD)、CHA_(2)DS_(2)-VASc评分均高于未复发组,差异均有统计学意义(P均<0.05)。多因素Logistic回归分析显示,房颤射频消融后复发的危险因素包括BMI、LAD和CHA_(2)DS_(2)-VASc评分。BMI、LAD、CHA_(2)DS_(2)-VASc评分、BMI+LAD+CHA_(2)DS_(2)-VASc评分预测房颤射频消融后复发的ROC曲线下面积分别为0.631、0.698、0.690、0.752。结论BMI、LAD联合CHA_(2)DS_(2)-VASc评分与房颤患者射频消融后复发密切相关,并具有一定的预测价值。

Objective To investigate the correlation among body mass index(BMI),left atrial diameter(LAD),CHA_(2)DS_(2)-VASc scores and recurrence in patients with atrial fibrillation(AF)after radiofrequency catheter ablation(RFCA).Methods AF patients undergone RFCA(n=219)were chosen from Department of Cardiology in Renmin Hospital of Wuhan University from Sept.2018 to Sept.2019.The clinical materials were collected and the patients were followed up.All patients were divided,according to follow-up results,into recurrence group(n=56)and non-recurrence group(n=163).The clinical materials and auxiliary examination results were compared between 2 groups.Results BMI,LAD,right atrial diameter(RAD)and CHA_(2)DS_(2)-VASc scores were all higher in recurrence group than those in non-recurrence group(all P<0.05).The results of multi-factor Logistic regression analysis showed that the risk factors of AF recurrence after RFCA included BMI,LAD and CHA_(2)DS_(2)-VASc scores.The area under ROC curve of BMI was 0.631,that of LAD was 0.698,that of CHA_(2)DS_(2)-VASc scores was 0.690 and that of BMI+LAD+CHA_(2)DS_(2)-VASc scores was 0.752.Conclusion BMI and LAD combined with LAD+CHA_(2)DS_(2)-VASc scores are closely correlated to AF recurrence after RFCA with some predictive value.