Predictive value of DR-FLASH score combined epicardial adipose tissue surrounding left atrium for left atrial low-voltage in patients with non-valvular atrial fibrillation
Predictive value of DR-FLASH score combined epicardial adipose tissue surrounding left atrium for left atrial low-voltage in patients with non-valvular atrial fibrillation
Objective To investigate the correlation between DR-FLASH score and epicardial adipose tissue(EAT)volume around the left atrium(LA),and explore the predictive value of their combination for left atrial low voltage zone(LVZ)in patients with non-valvular atrial fibrillation(NVAF).Methods A total of 268 NVAF patients who received radiofrequency catheter ablation for first time in Department of Cardiovascular Diseases,Affiliated Hospital of Xuzhou Medical University from September 2019 to April 2121 were consecutively recruited in this single-center retrospective clinical observation study.All patients underwent CTA scanning of pulmonary vein preoperatively,and then the volume of LA-EAT was measured.DR-FLASH score were calculated after admission.During the operation,the high-density voltage mapping of the LA was performed under sinus rhythm,and the patients were divided into LVZ group and non-LVZ group according to LVZ existence(bipolar voltage＜0.5 mV as low voltage area).SPSS statistics 24.0 was used for statistical analysis.Intergroup comparison was performed using student's t test,U test or Chi-square test depending on data type.Spearman correlation analysis was employed to determine the correlation between DR-FLASH score and LA-EAT volume.Receiver operating characteristic(ROC)curve was plotted to analyze the value of DR-FLASH score,LA-EAT volume and their combination to predict LVZ occurrence.Results In the subjected 246 patients,their average age was(60.8±10.6)years,and at least one LVZ was found in 56 patients(22.8％).The correlation analysis showed that the DR-FLASH score was positively corr-elated with LA-EAT volume(r=0.439;P＜0.001).Multivariate analysis revealed that DR-FLASH score(OR=1.824,95％CI 1.390-2.394;P＜0.001)and LA-EAT(OR=1.048,95％CI 1.013-1.085;P=0.007)were independent risk factors for LVZ after radiofrequency catheter ablation.The area under the ROC curve was 0.712,0.750 and 0.796,respectively for LA-EAT volume,DR-FLASH score,and their combination.Conclusion For NVAF patients,their DR-FLASH score is positively correlated with LA-EAT volume.The two indica-tors are independent predictors of left atrial LVZ in them.Their combination can improve the predictive value of left atrial LVZ.in NVAF patients with non-valvular atrial fibrillation.
关键词
心血管疾病/心房颤动/心外膜脂肪组织/心房纤维化/双极电压标测/DR-FLASH评分
Key words
cardiovascular diseases/atrial fibrillation/epicardial adipose tissue/atrial fibrosis/bipolar voltage mapping/DR-FLASH score
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