术前超声心动图左心房径线指数评价心房颤动患者心脏射频消融术后短期复发的临床研究

Preoperative Echocardiography Left Atrial Radius Index to Evaluate Short-Term Recurrence of Cardiac Radiofrequency Ablation in Patients with Atrial Fibrillation

摘要: 目的：探讨应用超声心动图左心房径线指数(LADi)评价心房颤动患者心脏射频消融术后短期复发的价值。方法：回顾性分析自2018年以来于我院诊断为心房颤动并首次接受心脏射频消融术患者242例，根据随访3~12个月内是否复发心房颤动，将其分为复发组(33例)和非复发组(209例)，分析两组患者的一般临床资料，行超声心动图检查收集左心房前后径(D1)、左心房左右径(D2)、左心房上下径(D3)，并计算径线平均值D，以体表面积标化D即为左心房径线指数(LADi)，采用logistic回归方程分析心房颤动复发的相关因素，并使用受试者工作特征(ROC)曲线评价左心房径线指数预测心房颤动复发的价值。结果：复发组LADi明显高于未复发组，且差异有统计学意义(P < 0.05)，回归分析显示，LADi为房颤短期复发的独立危险因素(OR = 1.251, 95% CI: 1.0931.431, P = 0.001)，ROC曲线分析显示，LADi预测RFCA后房颤复发的曲线下面积为0.675 (95% CI: 0.5790.771, P = 0.01)，LADi取截断值为27.54时，其敏感度为0.606，特异度0.695。结论：超声心动图左心房径线指数与RFCA术后房颤复发密切相关，有望成为临床预测RFCA术后房颤复发的新参数。

Abstract: Objective: To investigate the value of ultrasonography left atrial radius index (LADi) to evaluate short-term recurrence of cardiac radiofrequency ablation in patients with atrial fibrillation. Meth-ods: Retrospectively analyze 242 patients diagnosed with atrial fibrillation in our hospital since 2018 and undergoing radiofrequency ablation for the first time; patients were divided into recur-rent atrial fibrillation groups (33 cases) and non-relapsing groups (209 cases) according to whether they recurred atrial fibrillation within 3~12 months of follow-up; analyze the general clinical data of the two groups, perform echocardiography to collect the anteroposterior diameter of the left atrium (D1), left and right diameter of the left atrium (D2), upper and lower diameter of the left atrium (D3), and calculate the average radius D. The left atrial radius index (LADi) was standardized by body surface area, the logistic regression equation was used to analyze the relevant factors of atrial fibrillation recurrence, and the subject’s working characteristics (ROC) curve was used to evaluate the value of the left atrial radius index to predict the recurrence of atrial fibrillation. Results: The LADi of the relapse group was significantly higher than that of the non-relapse group, and the dif-ference was statistically significant (P < 0.05), and regression analysis showed that LADi was an in-dependent risk factor for short-term recurrence of atrial fibrillation (OR = 1.251, 95% CI: 1.0931.431, P = 0.001), and the ROC curve analysis showed that the area under the curve of LADi predicting atrial fibrillation recurrence after RFCA was 0.675 (95% CI: 0.5790.771, P = 0.01). When the cut-off value of LADi was 27.54, its sensitivity was 0.606 and its specificity was 0.695. Conclusion: The left atrial radius index of echocardiography was closely related to the recurrence of atrial fibrillation after RFCA, and was expected to become a new parameter for clinical prediction of recurrence of atrial fibrillation after RFCA.