Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean Circ J. 2011 Apr;41(4):177-83. doi: 10.4070/kcj.2011.41.4.177. Epub 2011 Apr 30.
Several predictors of recurrence of atrial fibrillation (AF) after ablation have been identified, including age, type of AF, hypertension, left atrial diameter and impaired left ventricular ejection fraction. The aim of this study was to investigate whether the atherosclerotic plaque thickness of the thoracic aorta is associated with a recurrence of AF after circumferential pulmonary vein ablation (CPVA).
Among patients with drug-refractory paroxysmal or persistent AF, 105 consecutive (mean age 58±11 years, male : female=76 : 29) patients who underwent transesophageal echocardiography and CPVA were studied. The relationships between the recurrence of AF and variables, including clinical characteristics, plaque thickness of the thoracic aorta, laboratory findings and echocardiographic parameters were evaluated.
A univariate analysis showed that the presence of diabetes {hazard ratio (HR)=3.425; 95% confidence interval (CI), 1.422-8.249, p=0.006}, ischemic heart disease (HR=4.549; 95% CI, 1.679-12.322, p=0.003), duration of AF (HR=1.010; 95% CI, 1.001-1.018, p=0.025), type of AF (HR=2.412, 95% CI=1.042-5.584, p=0.040) and aortic plaque thickness with ≥4 mm (HR=9.514; 95% CI, 3.419-26.105, p<0.001) were significantly associated with the recurrence of AF after ablation. In Cox multivariate regression analysis, only the aortic plaque thickness (with ≥4 mm) was an independent predictor of recurrence of AF after ablation (HR=7.250, 95% CI=1.906-27.580, p=0.004).
Significantly increased aortic plaque thickness can be a predictable marker of recurrence of AF after CPVA.
已经确定了一些预测房颤（AF）消融后复发的因素，包括年龄、AF 类型、高血压、左心房直径和左心室射血分数受损。本研究旨在探讨胸主动脉粥样硬化斑块厚度是否与环肺静脉消融（CPVA）后 AF 复发有关。
在药物难治性阵发性或持续性 AF 患者中，研究了 105 例连续（平均年龄 58±11 岁，男性：女性=76：29）接受经食管超声心动图和 CPVA 的患者。评估了 AF 复发与变量（包括临床特征、胸主动脉斑块厚度、实验室检查和超声心动图参数）之间的关系。
单因素分析显示，糖尿病存在（危险比[HR]=3.425；95%置信区间[CI]，1.422-8.249，p=0.006）、缺血性心脏病（HR=4.549；95%CI，1.679-12.322，p=0.003）、AF 持续时间（HR=1.010；95%CI，1.001-1.018，p=0.025）、AF 类型（HR=2.412，95%CI=1.042-5.584，p=0.040）和主动脉斑块厚度≥4mm（HR=9.514；95%CI，3.419-26.105，p<0.001）与消融后 AF 复发显著相关。在 Cox 多变量回归分析中，只有主动脉斑块厚度（≥4mm）是消融后 AF 复发的独立预测因子（HR=7.250，95%CI=1.906-27.580，p=0.004）。
明显增加的主动脉斑块厚度可能是 CPVA 后 AF 复发的可预测标志物。
