早期心电图指标定量分析对新发房颤患者药物转复失败的预测价值

Predictive value of early ECG index quantitative analysis for failure of drug conversion in patients with new-onset atrial fibrillation

目的探讨早期心电图指标定量分析对新发房颤患者药物转复失败的预测价值。方法选取2019年1月~2020年12月北京市大兴区人民医院收治的新发房颤患者112例,均接受药物转复,根据药物转复失败与否分为失败组(n=42)和成功组(n=70)。收集两组一般资料、实验室指标、超声心动图指标、心电图定量指标等,采用多因素Logistic回归分析影响新发房颤患者药物转复失败的相关因素,绘制ROC曲线并计算曲线下面积(AUC)分析早期心电图定量指标对新发房颤患者药物转复失败的预测价值。结果失败组糖尿病占比高于成功组(P<0.05),失败组血浆末端脑钠肽(NT-proBNP)、主频值(DF)、f波振幅(FWA)水平均高于成功组(均P<0.01);多因素Logistic回归分析显示:糖尿病(OR=3.470,95%CI 1.079~11.160)(P<0.05)、NT-proBNP(OR=1.002,95%CI 1.000~1.003)(P<0.05)、DF(OR=3.449,95%CI 1.927~6.171)(P<0.01)、FWA(OR=6240.863,95%CI 1.439~27057328.72)(P<0.05)为药物转复失败的危险因素;ROC曲线分析显示,DF[AUC=0.871,95%CI(0.794~0.927)];FWA[AUC=0.670,95%CI(0.574~0.759)];NT-proBNP[AUC=0.698,95%CI(0.604~0.781)];糖尿病[AUC=0.626,95%CI(0.530~0.716)],DF的AUC显著高于FWA、NT-proBNP、糖尿病(均P<0.05)。结论早期心电图定量指标FWA、DF可提高预测新发房颤患者药物转复失败的价值。

AIM To explore the predictive value of quantitative analysis of early ECG indicators for the failure of drug conversion in patients with new-onset atrial fibrillation.METHODS Prospectively selected 112 patients with new-onset atrial fibrillation admitted to ourhospital from January 2019 to December 2020,all of whom received drug conversion.According to whether the drug conversion failed or not,they were divided into failure group and success group.Collected two groups of general data,laboratory indicators,echocardiographic indicators,quantitative ECG indicators.Multivariate Logistic regression was used to analyze the factors affecting the failure of drug conversion in patients with newonset atrial fibrillation,and the ROC curve was drawn and the area under the curve(AUC)was calculated to analyze the predictive value of early electrocardiogram quantitative indicators for the failure of drug conversion in patients with new-onset atrial fibrillation.RESULTS The proportion of diabetes in the failure group was higher than that in the success group(P<0.05),and the plasma terminal brain natriuretic peptide(NT-proBNP),dominant frequency(DF),and f-wave amplitude(FWA)levels in the failure group were higher than those in the success group(all P<0.01);Multivariate Logistic regression analysis showed:diabetes(OR=3.470,95%CI 1.079-11.160)(P<0.05),NT-proBNP(OR=1.002,95%CI 1.000-1.003)(P<0.05),DF(OR=3.449,95%CI 1.927~6.171)(P<0.01),FWA(OR=6240.863,95%CI 1.439~27057328.72)(P<0.05)were risk factors for drug conversion failure;ROC curve analysis showed,DF[AUC=0.871,95%CI(0.794~0.927)];FWA[AUC=0.670,95%CI(0.574~0.759)];NT-proBNP[AUC=0.698,95%CI(0.604~0.781)];diabetes[AUC=0.626,95%CI(0.530-0.716)],AUC of DF was significantly higher than FWA,NT-proBNP,diabetes(all P<0.05).CONCLUSION The early quantitative indicators of ECG,FWA and DF,improve the value of predicting the failure of drug conversion in patients with new-onset atrial fibrillation.