冠周脂肪及甘油三酯-葡萄糖指数对不同类型心房颤动射频消融术后复发的预测价值

The predictive value of pericoronary adipose tissue and TyG index on recurrence after radiofrequency ablation in patients with different types of atrial fibrillation

目的探究冠周脂肪(PCAT)及甘油三酯-葡萄糖(TyG)指数对不同类型心房颤动(房颤)患者射频消融术(RFCA)后复发的影响。方法回顾性分析2018年8月—2022年12月首次且成功行RFCA的360例患者,分为持续性房颤(PersAF)组153例,及阵发性房颤(PAF)组207例,定期随访复发情况,根据术前冠状动脉CT血管成像(CCTA)测量PCAT相关参数,采集患者术前一般资料并计算TyG指数,比较两组患者临床及影像资料与复发情况。Cox回归分析复发的影响因素,受试者工作特征(ROC)曲线计算诊断效能。结果中位随访11.5个月后,87例患者复发,其中PersAF组47例,PAF组40例。多因素Cox回归分析显示,左回旋支脂肪衰减指数(LCX-FAI)为PersAF患者复发的独立危险因素(P<0.001);TyG指数为PersAF及PAF患者术后复发的独立危险因素(P<0.001)。LCX-FAI、TyG指数预测PersAF患者术后复发曲线下面积(AUC)分别为0.898、0.892,二者联合AUC为0.951。TyG指数预测PAF患者术后复发的AUC为0.842。结论TyG指数是PAF患者术后复发的独立危险因素,LCX-FAI和TyG指数可预测PersAF患者术后复发,二者联合预测价值更高。

Objective To investigate the effects of pericoronary fat(PCAT)and triglyceride glucose(TyG)index on recurrence after radiofrequency ablation(RFCA)in patients with different types of atrial fibrillation(AF).Methods A retrospective analysis was performed in 360 patients who underwent RFCA for the first time from August 2018 to December 2022.They were divided into 153 patients in the persistent atrial fibrillation(PersAF)group and 207 patients in the paroxysmal atrial fibrillation(PAF)group.The recurrence situation was regularly followed up,and PCAT related parameters were measured according to preoperative coronary CT angiography(CCTA).Preoperative general data of patients were collected and TyG index was calculated.Cox regression analysis was performed to analyze the influence factors of recurrence,and receiver operating characteristic(ROC)was used to calculate the diagnostic efficiency.Results After a median follow-up of 11.5 months,87 patients recurred,including 47 patients in the PersAF group and 40 patients in the PAF group.Multivariate Cox regression analysis showed that LCX-FAI was an independent risk factor for recurrence in PersAF patients(P<0.001).TyG index was an independent risk factor for postoperative recurrence in PersAF and PAF patients(P<0.001).AUC of LCX-FAI and TyG index in PersAF patients were 0.898 and 0.892,respectively,and the combined AUC was 0.951.AUC of TyG index in PAF patients was 0.842.Conclusion TyG index is an independent risk factor for postoperative recurrence in patients with PAF.LCX-FAI and TyG index can effectively predict postoperative recurrence in patients with PersAF.