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左心房容积指数在预测电复律后房颤复发中的意义。

The significance of the left atrial volume index in prediction of atrial fibrillation recurrence after electrical cardioversion.

作者信息

Toufan Mehrnoush, Kazemi Babak, Molazadeh Negin

机构信息

Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

J Cardiovasc Thorac Res. 2017;9(1):54-59. doi: 10.15171/jcvtr.2017.08. Epub 2017 Mar 18.

Abstract

Electrical cardioversion (ECV) is a safe method for the treatment of atrial fibrillation. It seems that left atrial volume index (LAVI) could be a good marker in predicting the success of ECV. The purpose of this study is to assess of the significance of LAVI measurement before ECV in predicting the recurrence of the AF. Fifty-one patients with AF, selected for ECV were studied in the cardiology department of Tabriz University of medical sciences. The clinical and demographic data of all the patients were obtained. Echocardiography was performed before and also three months after ECV. Patients were separated into two groups: those who maintained SR and those with relapse of AF diagnosed by clinical manifestations and electrocardiography (ECG). Sinus rhythm (SR) was maintained in 76.5 percent of the patients following the three months after ECV. The age, sex and the body mass index (BMI) were not significantly different between SR and AF groups. Two groups showed no significant differences considering pre-ECV medical history including medications and systemic diseases. The initial LAVI of SR group was 42.21±12.4 mL/m and AF group was 96.08±52.21 mL/m, the initial LAVI was significantly different between two groups ( = 0.000). The LAVI of SR group decreased significantly (5.69±0.74 mL/m) after three months, LAVI decreased from 42.21 ± 12.4 ml/m to 37.51 ± 10.52 mL/m. ( = 0.000). The cut-off point of LAVI value in predicting the maintenance of SR was 55 mL/m. The present study indicates that LAVI is a powerful forecaster of the recurrence of AF after ECV. The LAVI measurement could be a useful method in the selection of the patients with AF for ECV.

摘要

电复律(ECV)是治疗心房颤动的一种安全方法。左心房容积指数(LAVI)似乎可能是预测电复律成功的一个良好指标。本研究的目的是评估电复律前测量LAVI对预测房颤复发的意义。在大不里士医科大学心脏病学系对51例因电复律而入选的房颤患者进行了研究。获取了所有患者的临床和人口统计学数据。在电复律前及电复律后三个月均进行了超声心动图检查。患者被分为两组:维持窦性心律(SR)的患者和通过临床表现及心电图(ECG)诊断为房颤复发的患者。电复律后三个月,76.5%的患者维持窦性心律。SR组和房颤组在年龄、性别和体重指数(BMI)方面无显著差异。考虑到电复律前的病史,包括用药情况和全身性疾病,两组之间无显著差异。SR组的初始LAVI为42.21±12.4 mL/m²,房颤组为96.08±52.21 mL/m²,两组之间的初始LAVI有显著差异(P = 0.000)。三个月后,SR组的LAVI显著下降(5.69±0.74 mL/m²),LAVI从42.21±12.4 ml/m²降至37.51±10.52 mL/m²(P = 0.000)。预测维持SR的LAVI值的截断点为55 mL/m²。本研究表明,LAVI是电复律后房颤复发的有力预测指标。测量LAVI可能是选择房颤患者进行电复律的一种有用方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f79/5402028/f6d0da7d190e/jcvtr-9-54-g001.jpg

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