术前冠状动脉侧支循环不良可预测冠状动脉旁路移植术后房颤的发生。

Preoperative poor coronary collateral circulation can predict the development of atrial fibrillation after coronary artery bypass graft surgery.

作者信息

Gungor Hasan, Eryilmaz Ufuk, Akgullu Cagdas, Zencir Cemil, Kurtoglu Tunay, Selvi Mithat, Onay Sevil, Zorlu Ali, Ceyhan Ceyhun, Onbasili Alper, Tekten Tarkan

机构信息

Departments of aCardiology bCardiovascular Surgery, Faculty of Medicine, Adnan Menderes University, Aydin cDepartment of Cardiology, Malatya Hospital, Malatya, Turkey.

出版信息

Coron Artery Dis. 2013 Nov;24(7):572-6. doi: 10.1097/MCA.0000000000000025.

DOI:10.1097/MCA.0000000000000025

PMID:23965948

Abstract

AIM

Coronary collateral circulation (CCC) helps to protect and preserve myocardium from episodes of ischemia, and reduce angina symptoms, arrhythmia, and cardiovascular events. Atrial fibrillation (AF) is the most frequent form of arrhythmia after coronary artery bypass graft (CABG) surgery. The aim of this study was to investigate the association between CCC and the development of AF in patients undergoing CABG surgery.

METHODS

A total of 165 patients (mean age 63±10 years, 74% men, 26% women) who were undergoing CABG surgery at our department were enrolled into this study. Patients were categorized into two groups according to preoperative CCC using the Rentrop method.

RESULTS

Of the patients, 79 had poor CCC and 89 had good CCC. The AF incidence rate in the poor collateral group was significantly higher than that in the good collateral group [37 (49%) vs. 12 (14%), P<0.001]. In univariate analysis, age, left atrium size, and poor CCC grade were associated with AF after CABG surgery. Multivariate analysis showed that only poor CCC grade (odds ratio: 11.500; 95% confidence interval 3.977-33.253, P<0.001) was an independent predictor of the development of AF after adjustment of other potential confounders in patients undergoing CABG surgery.

CONCLUSION

The present study showed that preoperative poor CCC is a powerful predictor of the development of AF after CABG surgery.

摘要

目的

冠状动脉侧支循环（CCC）有助于保护心肌免受缺血发作的影响，并减轻心绞痛症状、心律失常和心血管事件。心房颤动（AF）是冠状动脉旁路移植术（CABG）后最常见的心律失常形式。本研究的目的是探讨CABG手术患者中CCC与AF发生之间的关联。

方法

本研究纳入了在我科接受CABG手术的165例患者（平均年龄63±10岁，男性74%，女性26%）。根据术前使用Rentrop方法评估的CCC将患者分为两组。

结果

患者中，79例CCC较差，89例CCC良好。侧支循环差的组中AF发生率显著高于侧支循环好的组[37例（49%）对12例（14%），P<0.001]。单因素分析中，年龄、左心房大小和CCC分级差与CABG术后AF相关。多因素分析显示，在调整CABG手术患者的其他潜在混杂因素后，只有CCC分级差（比值比：11.500；95%置信区间3.977 - 33.253，P<0.001）是AF发生的独立预测因素。