NT-proBNP及左房内径对慢性心力衰竭合并心房颤动射频术后复发的预测价值
Predictive Value of NT-proBNP and Left Atrial Diameter for Recurrence of Chronic Heart Failure Complicated with Atrial Fibrillation after Radiofrequency Surgery
摘要: 目的：探讨NT-proBNP及左房内径对慢性心力衰竭合并心房颤动射频术后复发的预测价值。方法：采用回顾性分析的方法，选取2020年3月~2020年9月因慢性心力衰竭合并心房颤动于青岛大学附属医院心内科接受射频消融术患者90例，收集患者的临床资料并进行随访，根据射频消融术后随访6个月结果分为复发组(n = 32)和非复发组(n = 58)，绘制ROC受试者工作特征(ROC)曲线，分析NT-ProBNP及左房内径对慢性心力衰竭合并持续性心房颤动患者射频消融术后复发的预测价值。房颤复发：射频消融术后3个月后行常规心电图或动态心电图记录到房颤、房扑或有大于30 s的房性心动过速均判为房颤复发。结果：两组间的性别、年龄、用药情况(ARB、安达唐、螺内酯)，合并疾病(高血压、糖尿病、扩心病、甲亢)、补体C1q、胱抑素C、尿酸、肌酐等方面差异无统计学意义(P > 0.05)，但复发组LAD、NT-proBNP均高于非复发组，差异具有统计学意义(P < 0.01)。NT-proBNP及左房内径可作为慢性心力衰竭合并房颤术后复发的独立危险因素，NT-proBNP及左房内径预测慢性心力衰竭合并房颤射频消融术后复发的ROC曲线下面积分别为0.7527 (95% CI: 0.6479, 0.8575, P < 0.0001)、0.83 (95% CI: 0.7348, 0.9252, P < 0.0001)。结论：对于慢性心力衰竭合并心房颤动患者，NT-proBNP及左房内径均是射频消融术后房颤复发的独立危险因素。
Abstract: Objective: To investigate the predictive value of NT-proBNP and left atrial diameter in patients with chronic heart failure complicated with atrial fibrillation after radiofrequency surgery. Methods: A retrospective analysis was performed on 90 patients undergoing radiofrequency ablation for chronic heart failure complicated with atrial fibrillation in the Department of Cardiology, Affiliated Hospital of Qingdao University from March 2020 to September 2020. Clinical data of the patients were collected and followed up. According to the results of 6-month follow-up after radiofrequency ablation, the patients were divided into recurrence group (n = 32) and non-recurrence group (n = 58). Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of NT-proBNP and left atrial diameter in patients with chronic heart failure complicated with persistent atrial fibrillation after radiofrequency ablation. Recurrence of atrial fibrillation: atrial fibrillation, atrial flutter or atrial tachycardia with more than 30 seconds recorded by routine electrocardiogram or dynamic electrocardiogram 3 months after radiofrequency ablation were judged as recurrence of atrial fibrillation. Results: There were no significant differences in gender, age, medication status (ARB, Andatang, spironolone), complicated diseases (hypertension, diabetes, enlarged heart disease, hyperthyroidism), complement C1q, cystatin C, uric acid and creatinine between the two groups (P > 0.05), but the LAD and NT-proBNP in the recurrence group were higher than those in the non-recurrence group. The difference was statistically significant (P < 0.01). NT-proBNP and left atrial diameter can be used as independent risk factors for postoperative recurrence of chronic heart failure combined with atrial fibrillation. The area under the ROC curve for NT-proBNP and left atrial diameter to predict recurrence of chronic heart failure combined with atrial fibrillation after radiofrequency ablation was 0.7527 (95% CI: 0.6479, 0.8575, P < 0.0001), 0.83 (95% CI: 0.7348, 0.9252, P < 0.0001). Conclusion: For patients with chronic heart failure complicated with atrial fibrillation, NT-proBNP and left atrial diameter are independent risk factors for atrial fibrillation recurrence after radiofrequency ablation.
文章引用：段晴晴, 阮士苗, 崔述霞, 韩晓荣, 刘松. NT-proBNP及左房内径对慢性心力衰竭合并心房颤动射频术后复发的预测价值[J]. 临床医学进展, 2022, 12(2): 921-927. https://doi.org/10.12677/ACM.2022.122134

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