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导管射频消融术对持续性和永久性心房颤动患者C反应蛋白、脑钠肽及超声心动图的影响

Effect of catheter radiofrequency ablation on C-reactive protein, brain natriuretic peptide and echocardiograph in patients with persistent and permanent atrial fibrillation.

作者信息

Huang Qiong, Yuan Yiqiang, Qiu Chunguang, Zhao Yujie, Mao Youlin, Wang Ruimin, Wang Qian

机构信息

Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.

Department of Cardiology, Zhengzhou Cardiovascular Hospital, Zhengzhou, Henan 450016, China.

出版信息

Chin Med J (Engl). 2014;127(4):623-6.

Abstract

BACKGROUND

Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has developed rapidly, and is a commonly performed ablation in many major hospitals throughout the world, due to its satisfactory results. The aim of this study was to detect the effect of RFCA on C-reactive protein (CRP), brain natriuretic peptide (BNP), and echocardiograph in patients with persistent and permanent AF.

METHODS

A total of 120 patients (71 males, mean age (50.8 ± 12.0) years) with persistent and permanent AF undergoing RFCA under guidance of the Carto merge technique were studied. Left atrial diameter (LAD), right atrial diameter (RAD), left ventricular ejection fraction (LVEF), CRP, and BNP were observed 3, 6 and 12 months after RFCA and compared with results before RFCA. The recurrence of atrial arrhythmias was observed 3 and 12 months after the procedure.

RESULTS

Compared with that before RFCA, LAD and RAD decreased and LVEF increased significantly after RFCA. Meanwhile, the levels of CRP and BNP were reduced significantly at 3, 6, and 12 months after RFCA (P < 0.05). In the non-recurrent patients, LVEF was increased significantly compared with the recurrent patients at 3, 6, and 12 months after RFCA (P < 0.05). CRP and BNP levels were decreased significantly in the non-recurrent patients compared with the recurrent patients at 3, 6, and 12 months after RFCA (P < 0.05). After one or two applications of RFCA, during a follow-up of 12 months, 12 patients (10.0%) had AF, 10 patients (8.3%) had atrial flutter, and 5 patients had atrial tachycardia (4.2%).

CONCLUSIONS

Conversion of AF to sinus rhythm by RFCA, has been shown to reduce LA size and improve LVEF. It can also significantly decrease the levels of CRP and BNP in patients with persistent and permanent AF and reduce the risk of inflammation and developing heart failure.

摘要

背景

心房颤动(AF)的射频导管消融术(RFCA)发展迅速,因其效果令人满意,在全球许多大型医院都是一种常用的消融术。本研究的目的是检测RFCA对持续性和永久性AF患者的C反应蛋白(CRP)、脑钠肽(BNP)及超声心动图的影响。

方法

共研究了120例接受Carto融合技术引导下RFCA的持续性和永久性AF患者(71例男性,平均年龄(50.8±12.0)岁)。在RFCA术后3个月、6个月和12个月观察左心房直径(LAD)、右心房直径(RAD)、左心室射血分数(LVEF)、CRP和BNP,并与RFCA术前结果进行比较。在术后3个月和12个月观察房性心律失常的复发情况。

结果

与RFCA术前相比,RFCA术后LAD和RAD减小,LVEF显著增加。同时,RFCA术后3个月、6个月和12个月时CRP和BNP水平显著降低(P<0.05)。在未复发患者中,RFCA术后3个月、6个月和12个月时LVEF较复发患者显著增加(P<0.05)。RFCA术后3个月、6个月和12个月时,未复发患者的CRP和BNP水平较复发患者显著降低(P<0.05)。在进行一或两次RFCA后,随访12个月期间,12例患者(10.0%)发生AF,10例患者(8.3%)发生心房扑动,5例患者发生房性心动过速(4.2%)。

结论

RFCA使AF转为窦性心律已显示可减小左心房大小并改善LVEF。它还可显著降低持续性和永久性AF患者的CRP和BNP水平,并降低炎症和发生心力衰竭的风险。

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