| 和燕斐,杨瑞,孙玉梅,黄琼,刘继伟,史征,葛红.左心房与肺静脉容积比预测导管消融术后心房颤动复发[J].中国医学影像技术,2023,39(3):356~360 |
| 左心房与肺静脉容积比预测导管消融术后心房颤动复发 |
| Left atrial volume/pulmonary vein volume for predicting recurrence of atrial fibrillation after catheter ablation |
| 投稿时间：2022-10-28 修订日期：2023-02-06 |
| DOI：10.13929/j.issn.1003-3289.2023.03.009 |
| 中文关键词: 心房颤动 导管消融 心房,左 肺静脉 血管造影术 体层摄影术,X线计算机 |
| 英文关键词:atrial fibrillation catheter ablation heart atria, left pulmonary veins angiography tomography, X-ray computed |
| 基金项目:2022年河南省医学会适宜技术推广项目（SYJS2022047）。 |
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| 中文摘要: |
| 目的 观察左心房容积（LAV）与肺静脉容积（PVV）比（LAV/PVV）预测导管消融术后心房颤动（AF）复发的价值。方法 纳入95例接受导管消融术治疗的AF患者，根据术后随访1年内有无AF复发将其分别归入复发组（n=23）与未复发组（n=72）。采用2种方法（方法1，对各支肺静脉均渲染至距肺静脉开口部后2 cm；方法2，对各支肺静脉均渲染至肺静脉分叉后1 cm）基于心脏CT血管成像（CTA）测量左肺上静脉容积（LSPVV）、左肺下静脉容积（LIPVV）、右肺上静脉容积（RSPVV）及右肺下静脉容积（RIPVV），计算LAV及PVV；比较2种方法测值，评估LAV/PVV预测导管消融术后AF复发的价值。结果 方法1、2所测LIPVV差异有统计学意义（P<0.05）。根据单因素分析结果，性别、年龄、体质量指数（BMI）、心力衰竭、LAV及LAV/PVV均为导管消融术后AF复发的危险因素；多因素分析结果显示，仅LAV/PVV为AF复发的危险因素。以8.27为方法1所获LAV/PVV的最佳截断值，其预测导管消融术后AF复发的曲线下面积（AUC）、敏感度及特异度分别为0.774、78.26%及70.83%；以9.02为方法2所获LAV/PVV的最佳截断值，其AUC、敏感度及特异度分别为0.691、56.52%及80.56%；以方法1所测量LAV/PVV预测导管消融术后AF复发的AUC高于方法2（P=0.018）。结论 LAV/PVV可用于预测经导管消融术后AF复发，且以方法1所获LAV/PVV的预测价值更高。 |
| 英文摘要: |
| Objective To observe the value of left atrial volume (LAA)/pulmonary vein volume (PVV) for predicting recurrence after catheter ablation in patients with atrial fibrillation(AF). Methods Totally 95 patients with AF who underwent catheter ablation were enrolled and divided into recurrent group (n=23) or non-recurrent group (n=72) according to AF recurred or not within 1 year after treatment. Based on cardiac CT angiography (CTA), left superior PVV (LSPVV), left inferior PVV (LIPVV), right superior PVV (RSPVV) and right inferior PVV (RIPVV) were measured using 2 methods (method 1, rendering each pulmonary vein to 2 cm behind the opening of the pulmonary vein; method 2, rendering each pulmonary vein to 1 cm after the bifurcation of the pulmonary vein), and LAV and PVV were calculated. The results were compared between methods, and the value of LAV/PVV for predicting recurrence of AF after catheter ablation was explored. Results Significant difference of LIPVV was found between measured method 1 and 2 (P<0.05). Univariate analysis showed that sex, age, body mass index (BMI), heart failure, LAV and LAV/PVV were all risk factors of AF recurrence after catheter ablation, while multivariate analysis showed that only LAV/PVV was the risk factor. Taken 8.27 as the best cut-off value of LAV/PVV obtained with method 1, the area under the curve (AUC), sensitivity and specificity for predicting AF recurrence after catheter ablation was 0.774, 78.26% and 70.83%, respectively. Taken 9.02 as the best cut-off value of LAV/PVV obtained with method 2, the AUC, sensitivity and specificity was 0.691, 56.52% and 80.56%, respectively, and AUC of LAV/PVV obtained with method 1 was higher than that with method 2 (P=0.018). Conclusion LAV/PVV could be used to predict AF recurrence after catheter ablation, and the value of LAV/PVV obtained with method 1 was better than with method 2. |
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