心外膜脂肪厚度及左房参数对房颤患者射频消融术后复发的预测价值

The predictive value of epicardial adipose tissue thickness and left atrial parameters for recurrence after radiofrequency ablation in patients with atrial fibrillation

目的:探讨超声心动图评估心外膜脂肪(EAT)厚度、左房结构及功能参数对房颤(AF)患者射频消融术后复发的预测价值。方法:选取2022年5月—2023年5月在兰州大学第一医院心内科收治的64例拟行射频消融术的AF患者为观察组,根据随访结果分为复发组和未复发组。两组均于术前采集超声心动图图像,测量并记录患者超声数据,比较两组数据有无差异,寻找并分析复发患者的相关危险因素。采用受试者工作特征(ROC)曲线分析各参数对AF患者射频消融术后复发的预测价值。结果:LAVmax、LAVmin、LAVImax、LAVImin、LA Tmsv-SD、EAT厚度复发组较未复发组明显增加,LV GLS、LAEF、LASr、LASct复发组较未复发组明显减低,差异有统计学意义(P<0.05),Logistic回归分析显示LAVImin、EAT厚度、LASct及LA Tmsv-SD是AF复发的独立预测因子。ROC曲线分析显示,LA Tmsv-SD、LASct、LAVImin、EAT厚度预测复发的曲线下面积(AUC)分别为0.774(95%Cl:0.636~0.911,P<0.001)、0.751(95%Cl:0.629~0.872,P=0.001)、0.730(95%Cl:0.596~0.864,P=0.03)、0.743(95%Cl:0.603~0.884,P=0.002)。结论:LAVImin、EAT厚度、LASct及LA Tmsv-SD均可作为射频消融术后AF复发的预测因子,且LA Tmsv-SD的预测效能更优。

Objective:To explore the predictive value of echocardiography in evaluating epicardial adipose tissue(EAT)thickness,left atrial structure and functional parameters for recurrence after radiofrequency ablation in patients with atrial fibrillation(AF).Methods:A total of 64 patients with AF who were admitted to the Department of Cardiology at the First Hospital of Lanzhou University from May 2022 to May 2023 and planned to undergo radiofrequency ablation were selected as the observation group.According to the follow-up results,they were divided into a recurrence group and a non-recurrence group.Both groups collected echocardiography images before surgery,measured and recorded patient ultrasonic data,compared the differences between the two groups,and identified and analyzed relevant risk factors of recurrence in patients.Using receiver operating characteristic(ROC)curve to analyze the predictive value of various parameters for recurrence after radiofrequency ablation in AF patients.Results:Compared with the non-recurrence group,LAVmax,LAV_(min),LAVI_(max),LAVI_(min),LA Tmsv-SD,and EAT thickness increased in the recurrence group.Compared with the non-recurrence group,LV GLS,LAEF,LASr,and LASct decreased in the recurrence group with a statistically significant difference(P<0.05).Logistic regression analysis showed that LAV_(min),EAT thickness,LASct,and LA Tmsv SD were independent predictors of AF recurrence.ROC curve analysis showed that the area under the curve(AUC)for predicting recurrence in LA Tmsv SD,LASct,LAVI_(min),and EAT thickness was 0.774(95%Cl:0.636~0.911,P<0.001),0.751(95%Cl:0.629~0.872,P=0.001),0.730(95%Cl:0.596~0.864,P=0.03),and 0.743(95%Cl:0.603~0.884,P=0.002),respectively.Conclusion:LAVI_(min),EAT thickness,LASct,and LA Tmsv SD can all be used as predictive factors for AF recurrence after radiofrequency ablation,and LA Tmsv SD has better predictive efficacy.