Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China; Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):834-840. doi: 10.1016/j.numecd.2020.12.003. Epub 2020 Dec 10.
Both malnutrition and atrial fibrillation (AF) are the major health problems in modern society. Only a few studies focused on the relationship between malnutrition and recurrence of atrial arrhythmias post AF ablation (AF recurrence), which used body mass index (BMI) as nutrition assessment tool. However, BMI can't credibly reflect body composition and has limitation in patients with water-sodium retention. In this study, we used controlling nutritional status score (CONUT score) and geriatric nutritional risk index (GNRI) to identify the malnutrition patients and explored the effect of malnutrition on AF recurrence.
This retrospective study included 246 patients who underwent AF ablation. During a median 11-month follow-up, 77 patients (31.3%) experienced AF recurrence. The recurrence group had higher CONUT score (2.3 ± 1.5 vs. 0.9 ± 1.0, P < 0.001) and lower GNRI (99.9 ± 7.6 vs. 103.9 ± 5.6, P < 0.001). After balancing the traditional risk factors, both CONUT score (OR: 2.614, 95%CI: 1.831-3.731, P < 0.001) and GNRI (OR: 0.884, 95%CI: 0.828-0.944, P < 0.001) were the independent predictors for AF recurrence. Pre-ablation CONUT score ≥1 and GNRI≥95.66 are indicative of AF recurrence. Adding CONUT score or GNRI to the base prediction model for AF recurrence significantly improved the discrimination and calibration. However, adding BMI to the base prediction model did not improve the model performance.
CONUT score and GNRI are ideal tools to evaluate the nutrition status of AF patients. Undernourished patients are more likely to suffer from AF recurrence. Improving nutrition status may be a potential target for reducing the postoperative recurrence rate.
营养不良和心房颤动（AF）都是现代社会的主要健康问题。只有少数研究关注营养不良与 AF 消融后心房心律失常复发（AF 复发）之间的关系，这些研究使用体重指数（BMI）作为营养评估工具。然而，BMI 不能可靠地反映身体成分，并且在水钠潴留的患者中存在局限性。在本研究中，我们使用控制营养状况评分（CONUT 评分）和老年营养风险指数（GNRI）来识别营养不良患者，并探讨营养不良对 AF 复发的影响。
这项回顾性研究纳入了 246 例行 AF 消融的患者。在中位 11 个月的随访期间，77 例患者（31.3%）发生 AF 复发。复发组的 CONUT 评分较高（2.3±1.5 与 0.9±1.0，P<0.001），GNRI 较低（99.9±7.6 与 103.9±5.6，P<0.001）。在平衡传统危险因素后，CONUT 评分（OR：2.614，95%CI：1.831-3.731，P<0.001）和 GNRI（OR：0.884，95%CI：0.828-0.944，P<0.001）均为 AF 复发的独立预测因素。消融前 CONUT 评分≥1 和 GNRI≥95.66 提示 AF 复发。添加 CONUT 评分或 GNRI 可显著提高 AF 复发的预测模型的区分度和校准度。然而，将 BMI 添加到基础预测模型中并不能提高模型性能。
CONUT 评分和 GNRI 是评估 AF 患者营养状况的理想工具。营养不足的患者更有可能发生 AF 复发。改善营养状况可能是降低术后复发率的潜在目标。
