袁含茵,杨颖,范芳芳,李康,王禹川,陈尔冬,贺鹏康,刘菲菲,蒋捷,周菁,丁燕生

• 1:北京大学第一医院心内科
• 2:北京市第六医院心内科
• 3:北京大学第一医院老年内科

摘要(Abstract)：

目的 探讨超声心动图评价的左、右心房应变对阵发性心房颤动（房颤）患者导管消融术后复发的影响。方法 纳入2014—2018年因阵发性房颤首次行导管消融术的患者，收集基本信息、病史、术前超声心动图、手术信息及术后1年房颤是否复发等信息。比较复发组与非复发组基线临床资料和超声心动图参数，采用LASSO回归筛选与术后1年复发相关的超声心动图参数，将筛选出的参数与临床资料共同纳入多因素Logistic回归模型，探讨心房功能参数与导管消融术后复发的关系，并在左心房容积正常和扩大的病例中进行亚组分析。结果 240例患者纳入分析，1年内复发组80例，未复发组160例。复发组患者与未复发组比较，左心房容积指数增大[（42.88±16.83)ml/m~2比（38.92±11.37)ml/m~2,P=0.047]，左心房总体应变降低[21.70(11.16,31.84）比27.91(18.28,36.70),P=0.008]，右心房总体应变降低[26.93(17.32,40.31）比34.20(22.65,50.45),P=0.020]。用LASSO回归筛选出左心房和右心房总体应变两个参数纳入多因素Logistic回归模型，分析显示左心房总体应变是术后1年复发的独立危险因素（OR 0.97,95%CI 0.95～1.00,P=0.024），右心房总体应变对复发无影响。左心房容积指数正常和扩大的亚组中，左心房总体应变的水平不影响复发的风险，交互作用（P=0.245）；在左心房容积指数≤34 ml/m~2的患者中，右心房总体应变是复发的独立危险因素，应变值较高者复发率较低；而在左心房容积指数>34 ml/m~2的患者中，右心房总体应变不影响复发的风险，交互作用（P=0.016）。结论 左心房总体应变是阵发性房颤导管消融术后1年复发的独立危险因素；在左心房容积指数正常的患者中，右心房总体应变是复发的独立危险因素。

关键词(KeyWords)： 心房颤动;导管消融术;超声心动图;心房应变

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 袁含茵,杨颖,范芳芳,李康,王禹川,陈尔冬,贺鹏康,刘菲菲,蒋捷,周菁,丁燕生

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