国际老年医学杂志2025,Vol.46Issue(1) :5-9.DOI:10.3969/j.issn.1674-7593.2025.01.002

心外膜脂肪层厚度对心房颤动伴左心室肥大患者射频消融术后左心室逆重构的预测价值

Predictive value of epicardial fat thickness for left ventricular reverse remodeling after radiofrequency ablation in atrial fibrillation patients with left ventricular hypertrophy

胡可 王文晖 甄俊平 康春松
国际老年医学杂志2025,Vol.46Issue(1) :5-9.DOI:10.3969/j.issn.1674-7593.2025.01.002

心外膜脂肪层厚度对心房颤动伴左心室肥大患者射频消融术后左心室逆重构的预测价值

Predictive value of epicardial fat thickness for left ventricular reverse remodeling after radiofrequency ablation in atrial fibrillation patients with left ventricular hypertrophy

胡可 1王文晖 2甄俊平 2康春松3
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作者信息

  • 1. 山西医科大学,太原 030607;山西省白求恩医院,太原 030001
  • 2. 山西医科大学,太原 030607
  • 3. 山西省白求恩医院,太原 030001
  • 折叠

摘要

目的 探讨心外膜脂肪层厚度(EFT)对心房颤动伴左心室肥大患者射频消融术后左心室逆重构的预测价值.方法 选取2021年6月-2023年9月在山西省白求恩医院收治的心房颤动患者50例进行回顾性分析.通过电子病历采集患者的临床资料,采用超声心动图检查EFT,依据患者是否实现逆重构进行分组,单因素及多因素logistic回归模型分析术后左心室逆重构的影响因素,ROC曲线分析EFT对其预测价值.结果 28例未实现逆重构者为对照组,22例实现逆重构者为逆重构组.两组年龄、心房颤动分型、心房颤动病程、左房内径(LAD)、左室舒张末期内径、左室舒张末期内径指数(LVEDI)、中性粒细胞与淋巴细胞比值(NLR)、超敏C反应蛋白(hsCRP)、血小板分布宽度(PDW)、红细胞分布宽度、纤维蛋白原与白蛋白比值(FAR)及EFT比较,差异均有统计学意义(P<0.05);多因素logistic回归分析显示,EFT、LAD、LVEDI、NLR、hsCRP、PDW、FAR均为术后逆重构的独立影响因素(P<0.05);EFT预测术后左心室逆重构的 cut-off 值为 0.848,灵敏度为 95.5%,特异度为 89.3%,AUC 为 0.937(95%CI:0.868~0.983).结论 EFT与心房颤动伴左心室肥大患者术后左心室逆重构有较高的相关性.

Abstract

Objective To investigate the predictive value of epicardial fat thickness(EFT)for left ventricular reverse re-modeling after radiofrequency ablation in patients with left ventricular hypertrophy.Methods A total of 50 patients with atrial fibrilla-tion admitted to Shanxi Bethune Hospital from June 2021 to September 2023 were retrospectively collected.The clinical data of the pa-tients were collected by electronic medical records.EFT was examined by echocardiography.The patients were divided into groups ac-cording to whether reverse remodeling was achieved.Univariate and multivariate logistic regression models were used to analyze the fac-tors of postoperative left ventricular reverse remodeling.ROC curve was used to analyze the predictive value of EFT.Results A total of 28 patients who did not achieve reverse remodeling were included in the control group,and 22 patients who achieved reverse remodeling were included in the reverse remodeling group.There were significant differences in age,atrial fibrillation classification,duration of at-rial fibrillation,left atrial diameter(LAD),left ventricular end-diastolic diameter,left ventricular end-diastolic diameter index(LVE-DI),neutrophil to lymphocyte ratio(NLR),high-sensitivity C-reactive protein(hsCRP),platelet distribution width(PDW),red cell distribution width,fibrinogen to albumin ratio(FAR)and EFT between the two groups(P<0.05).Multivariate logistic regres-sion analysis showed that EFT,LAD,LVEDI,NLR,hsCRP,PDW and FAR were independent factors for left ventricular reverse re-modeling(P<0.05).The cut-off value of EFT for predicting postoperative left ventricular reverse remodeling was 0.848,sensitivity was 95.5%,specificity was 89.3%,and AUC was 0.937(95%CI:0.868-0.983).Conclusion EFT has a high predictive value for postoperative left ventricular reverse remodeling in patients with left ventricular hypertrophy.

关键词

心房颤动/左心室肥大/射频消融/左心室逆重构/心外膜脂肪层厚度

Key words

Atrial fibrillation/Left ventricular hypertrophy/Radiofrequency ablation/Left ventricular reverse remodeling/Epicardial fat thickness

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出版年

2025
国际老年医学杂志
吉林大学

国际老年医学杂志

影响因子:0.435
ISSN:1674-7593
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