CT评估阿托伐他汀对心房颤动术后心外膜脂肪及复发率的影响

CT Evaluation of the Impact of Atorvastatin on Epicardial AdiposeTissue and Recurrence Rates After Atrial Fibrillation Surgery

目的 基于CT成像探究阿托伐他汀的使用对心房颤动患者心外膜脂肪容积(EATV)、心外膜脂肪CT衰减(EAT CT attention)及导管射频消融(RFCA)术后复发率的影响。方法 回顾性搜集2020年4月至2022年12月在济南市中心医院接受RFCA的192例心房颤动患者数据,根据术后是否服用阿托伐他汀分为A组(116例,服用阿托伐他汀)和B组(76例,未服用阿托伐他汀)。两组患者在术前及术后6个月进行左心耳CT增强检查,并使用西门子后处理软件计算EATV和EAT CT attention。结果 术后6个月,A组患者的EATV和EAT CT attention显著降低并与B组患者的EATV和EAT CT attention相比差异具有统计学意义[EATV:(-4±15) ml vs.(1±12) ml,P=0.013;EAT CT attention:(-2±6) HU vs.(1±6) HU,P<0.001]。在18个月的随访中,A组的心房颤动复发率显著低于B组(20例vs.32例,P<0.001)。单因素Cox回归分析显示,阿托伐他汀使用和EATV降低是减少心房颤动复发的有利因素。在校正年龄、性别、身体质量指数(BMI)及心房颤动类型后,多因素Cox回归分析结果表明,阿托伐他汀仍显著降低复发风险[HR=0.522(0.289,0.944),P=0.003]。结论 应用阿托伐他汀与心房颤动患者CT增强EATV及EAT CT attention降低存在相关性,并与RFCA术后心房颤动复发率降低相关,可为临床上改善心房颤动患者预后提供新的治疗思路。

Objective To investigate the Impact of Atorvastatin on Epicardial Adipose Tissue Volume(EATV),epicardial adipose tissueCT attenuation(EAT CT attenuation),and Post-Radiofrequency Catheter Ablation(RFCA)Recurrence Rates in Atrial Fibrillation Patients Based on CT Imaging.Methods A retrospective analysis was conducted on data from 192 AF patients who underwent RFCA at Jinan Central Hospital between April 2020 and December 2022.Patients were divided into Group A(116 patients receiving atorvastatin)and Group B(76 patients not receiving atorvastatin)based on post-operative atorvastatin use.Both groups underwent left atrial appendage CT enhancement before and 6 months after the procedure,with EATV and EAT CT attenuation calculated using Siemens post-processing software.Results Six months post-operation,EATV and EAT CT attenuation were significantly reduced in Group A(EATV:(-4±15)ml vs.(1±12)ml,P=0.013;EAT CT attenuation:(-2±6)HU vs.(1±6)HU,P<0.001).At 18 months of follow-up,the recurrence rate of AF in Group A was significantly lower than in Group B(20 cases vs 32 cases,P<0.001).Univariate Cox regression analysis indicated that atorvastatin use and reduction in EATV were beneficial factors in reducing AF recurrence.After adjusting for age,gender,body mass index(BMI),and AF type,multivariate Cox regression analysis showed that atorvastatin significantly reduced the risk of recurrence[HR=0.522(0.289,0.944),P=0.003].Conclusion The use of atorvastatin is associated with a reduction in EATV and EAT CT attention in AF patients as observed through enhanced CT imaging and is linked to a lower recurrence rate after RFCA.These findings provide new insights for improving the prognosis of AF patients.