心房颤动射频消融术后复发和非复发患者左房心外膜脂肪衰减值和体积的比较

Comparison of left atrial epicardial adipose tissue attenuation and volume between recurrent and non-recurrent patients with atrial fibrillation after radiofrequency ablation

目的探索左房心外膜脂肪(LA-EAT)是否为非瓣膜病心房颤动(AF)患者射频消融术后复发的一个可能危险因素。方法连续纳入首次行导管消融的226例非瓣膜病AF患者,所有患者术前均进行左房CTA检查,利用(Advantage Workstation4.6,GE,USA)工作站软件分析测量LA-EAT衰减值和体积。在门诊对患者进行随访,AF复发定义为射频消融术3个月后心电图记录到AF或房性心动过速发作持续>30 s。根据随访期间有无复发分为复发组和未复发组。结果中位随访时间10.7个月,57例(25.22%)患者发生复发。与非复发组比较,复发组基础资料比较为女性占比大(42.1%vs 28.4%,P<0.05),持续性AF的病例多(57.9%vs 36.7%,P<0.01)。复发组的LA-EAT衰减值低于非复发组[(-97.32±7.02)HU vs(-91.07±6.23)HU,P=0.001]、LA-EAT体积高于非复发组[(33.71±12.93)cm^(3) vs(28.15±11.46)cm^(3),P=0.003]。结论LA-EAT衰减值和体积可能与非瓣膜病AF导管消融后复发有关。

Objective To explore whether left atrial epicardial adipose tissue(LA-EAT) is a possible factor for atrial fibrillation(AF) recurrence after radiofrequency ablation in patients with non-valvular AF. Methods Two hundred and twenty-six consecutive patients with non-valvular AF undergoing catheter ablation for the first time were enrolled. All patients underwent left atrial CTA examination before ablation. LA-EAT attenuation and volume were analyzed and measured using(Advantage Workstation 4.6, GE, USA) workstation software. Patients were followed up on an outpatient basis, and recurrence of AF was defined as AF or atrial tachycardia lasting more than the 30 s 3 months after radiofrequency ablation. The patients were divided into the recurrence and non-recurrence groups according to the follow-up results. Results The median follow-up time was 10.7 months, and 57 patients(25.22%) had a recurrence of AF. Compared with the non-recurrent group(n=169), the proportion of women in the recurrent group was higher(42.1% vs 28.4%, P<0.05), and there were more cases of persistent AF in the recurrent group(57.9% vs 36.7%, P<0.01). The LA-EAT attenuation in the recurrent group was lower than that in the no recurrent group [(-97.32±7.02)HU vs(-91.07±6.23)HU, P=0.001], and the LA-EAT volume [(33.71±12.93)cm~3 vs(28.15±11.46)cm~3, P=0.003] was higher in the recurrent group than that in the no recurrent group. Conclusion The LA-EAT attenuation and volume may be related to the recurrence of non-valvular AF after catheter ablation.