左心房径线CT测量值与房颤射频消融术后复发的相关性

承德医学院学报 ›› 2022, Vol. 39 ›› Issue (4): 289-293.

左心房径线CT测量值与房颤射频消融术后复发的相关性

王妍¹, 励晔¹, 李金磊¹, 常英伟¹, 崔志新^1,*, 黄贤胜²

1.承德医学院附属医院放射科,河北承德 067000;
2.承德医学院附属医院心脏内科

收稿日期:2021-12-25 出版日期:2022-08-10 发布日期:2022-10-25
通讯作者: *

Correlation between CT Measurement of Left Atrial Diameter and Recurrence of Atrial Fibrillation after Radiofrequency Ablation

WANG Yan¹, LI Ye¹, LI Jin-lei¹, CHANG Ying-wei¹, CUI Zhi-xin^1,*, HUANG Xian-sheng²

1. Department of Radiology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, 067000, China;
2. Department of Cardiology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, 067000, China

Received:2021-12-25 Online:2022-08-10 Published:2022-10-25

摘要/Abstract

摘要： 目的探讨左心房及肺静脉径线CT测量值对阵发性房颤患者导管内射频消融（RFCA）术后复发的预测价值。方法选取于承德医学院附属医院诊断为房颤并首次行射频消融手术的阵发性房颤患者66例作为病变组,选取40名健康体检患者作为对照组,所有患者均行左心房及肺静脉CT血管造影检查,测量左心房横径及面积、肺静脉开口的径线及面积、房椎比等数据,并进行组间对照分析;术后3、6、12个月再次行CT检查,依据术后随访患者情况,将患者分为复发组与治愈组,将复发组与治愈组数据进行对照分析。结果观察组与对照组右上肺静脉（RSPV）面积、右下肺静脉（RIPV）前后径及面积、左上肺静脉（LSPV）径线及面积比较差异有统计学意义（P<0.05）;术后复发组与治愈组间对比分析,左房-椎体面积比（LAVA）、左房-椎体径线比（LAVD）、RSPV面积及RIPV前后径之间差异有统计学意义（P<0.05）;纳入Logistic回归分析,结果提示,LAVA是预测RFCA复发的独立危险因素。结论左心房及肺静脉径线CT测量值与房颤术后复发率密切相关,且LAVA可以作为RFCA术后复发的独立的预测指标。

关键词: 左心房径线, 房颤, 射频消融术, 复发, 预测因素, 多排螺旋CT

Abstract: Objective To investigate the predictive value of CT measurements of left atrium and pulmonary vein diameter for recurrence after radiofrequency catheter ablation (RFCA) in patients with primary atrial fibrillation. Methods Sixty-six patients with paroxysmal atrial fibrillation who were diagnosed as atrial fibrillation in the Affiliated Hospital of Chengde Medical University and underwent radiofrequency ablation for the first time were selected as the lesion group, and 40 healthy people were selected as the control group. All patients underwent CT angiography of left atrium and pulmonary vein. The transverse diameter and area of left atrium, the diameter and area of pulmonary vein opening, and the ratio of atrium to vertebra were measured, and the data were analyzed between groups. CT examination was performed again 3, 6 and 12 months after operation. According to the follow-up of patients, the patients were divided into recurrence group and cure group. The data of recurrence group and cure group were compared and analyzed. Results There were significant differences in the area of right superior pulmonary vein (RSPV), the anterior and posterior diameter and area of right inferior pulmonary vein (RIPV), and the diameter and area of left superior pulmonary vein (LSPV) between the observation group and the control group (P<0.05). There were significant differences in the left atrio-vertebral area ratio (LAVA), the left atrio-vertebral diameter ratio (LAVD), the area of RSPV and the anterior and posterior diameter of RIPV between the recurrence group and the cure group (P<0.05). Logistic regression analysis showed that LAVA was an independent risk factor for RFCA recurrence. Conclusion CT measurements of left atrium and pulmonary vein are closely related to the recurrence rate of atrial fibrillation after RFCA, and LAVA can be used as an independent predictor of recurrence after RFCA.

Key words: left atrial dimensional, atrial fibrillation, radiofrequency ablation, recurrence, predictive factors, multidetector spiral computed tomography

中图分类号:

R541

王妍, 励晔, 李金磊, 常英伟, 崔志新, 黄贤胜. 左心房径线CT测量值与房颤射频消融术后复发的相关性[J]. 承德医学院学报, 2022, 39(4): 289-293.

WANG Yan, LI Ye, LI Jin-lei, CHANG Ying-wei, CUI Zhi-xin, HUANG Xian-sheng. Correlation between CT Measurement of Left Atrial Diameter and Recurrence of Atrial Fibrillation after Radiofrequency Ablation[J]. Journal of Chengde Medical University, 2022, 39(4): 289-293.

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