心脏增强CT评估左心耳封堵术后装置内皮化的研究

The value of cardiac computed tomography in assessing device endothelialization after left atrial appendage closure

目的利用心脏增强CT评估左心耳封堵(Watchman,美国波士顿科学公司)术后装置的内皮化。方法本研究为单中心回顾性研究,连续入选2017年3月至2021年7月在上海交通大学医学院附属新华医院收治的的非瓣膜性心房颤动患者,进行左心耳封堵手术治疗,术后6个月应用心脏增强CT评估装置内皮化程度。结果研究纳入64例患者,年龄(74.8±8.4)岁,其中男42例(65.6%,42/64),女22例(34.4%,22/64)。所有患者均成功植入左心耳封堵装置,术后6个月心脏增强CT显示,40例(62.5%,40/64)患者封堵装置完全内皮化(内皮化组),24例(37.5%,24/64)患者装置不完全内皮化(不完全内皮化组)。完全内皮化组的总胆固醇[(3.91±1.00)mmol/L对(3.40±0.73)mmol/L,P=0.036]、甘油三酯[(1.44±0.74)mmol/L对(1.02±0.45)mmol/L,P=0.009]、低密度脂蛋白[(2.19±0.86)mmol/L对(1.68±0.51)mmol/L,P=0.005]水平均明显高于不完全内皮化组,差异具有统计学意义。结论利用心脏增强CT可评估左心耳封堵术后内皮化。

Objective This study aimed to evaluate endothelialization of left atrial appendage closure(LAAC)device(Watchman,Boston Scientific Corporation,USA)by cardiac computed tomography(CCT).Methods This was a single center retrospective study.Patients with non-valvular atrial fibrillation who underwent Watchman left atrial appendage closure were consecutively enrolled.Cardiac CT was used to evaluate the endothelialization degree of Watchman device at 6-month follow-up post procedure.Results A total of 64 patients were included.The age was(74.8±8.4)years old,and 22(34.4%,22/64)of them were female.Watchman device was successfully implanted in each patient.At 6-month follow-up,complete endothelialization were detected in 40 patients(62.5%,40/64),while incomplete endothelialization were detected in 24 patients(37.5%,24/64).The levels of cholesterol[(3.91±1.00)mmol/L vs.(3.40±0.73)mmol/L,P=0.036],triglyceride[(1.44±0.74)mmol/L vs.(1.02±0.45)mmol/L,P=0.009]and low density lipoprotein[(2.19±0.86)mmol/L vs.(1.68±0.51)mmol/L,P=0.005]was higher in complete endothelialized group,than that of in incomplete endothelialized groups.Conclusion It is feasible to evaluate the degree of endothelialization of Watchman device post LAAC by CCT.