左卡尼汀在主动脉瓣手术中预防术后心房颤动的应用。
L-Carnitine supplementation for the prevention of postoperative atrial fibrillation in aortic valve surgery.
机构信息
Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-Ku, Sapporo, 060-8638, Japan.
Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
出版信息
Gen Thorac Cardiovasc Surg. 2021 Nov;69(11):1460-1466. doi: 10.1007/s11748-021-01616-2. Epub 2021 Mar 10.
OBJECTIVES
L-Carnitine, a quaternary amine, improves fatty acid metabolism in the heart and has anti-inflammatory effects. Several studies have reported the efficacy of L-carnitine for the prophylaxis of arrhythmia. We assessed the clinical effectiveness of L-carnitine in preventing postoperative atrial fibrillation (POAF) in aortic valve surgery.
METHODS
Thirty patients who underwent aortic valve surgery were included. Fifteen patients had no prophylaxis other than conventional measures (control), while 15 patients received oral L-carnitine for 9 days (daily dose of 3 g). The incidence of POAF during 1 week after surgery was compared between the two groups. The multivariable logistic regression analysis for POAF was performed using the pre- and intraoperative parameters.
RESULTS
Preoperative characteristics and operative data were comparable between the groups. The POAF rate was significantly lower in the L-carnitine group than in the control (20% and 60%, respectively; P = 0.025). L-Carnitine use was an independently negative predictor for POAF (odds ratio 0.067; 95% confidence interval 0.006-0.768).
CONCLUSIONS
L-Carnitine administration may have potential for the prevention of POAF in aortic valve surgery.
目的
左旋肉碱是一种季铵碱，可改善心脏的脂肪酸代谢，具有抗炎作用。多项研究报告了左旋肉碱预防心律失常的疗效。我们评估了左旋肉碱预防主动脉瓣手术术后心房颤动（POAF）的临床效果。
方法
纳入 30 例接受主动脉瓣手术的患者。15 例患者除常规措施外未进行预防（对照组），而 15 例患者接受口服左旋肉碱 9 天（每日剂量 3g）。比较两组术后 1 周内 POAF 的发生率。使用术前和术中参数对 POAF 进行多变量逻辑回归分析。
结果
两组患者的术前特征和手术数据相当。左旋肉碱组 POAF 发生率明显低于对照组（分别为 20%和 60%；P=0.025）。左旋肉碱的使用是 POAF 的独立负预测因子（比值比 0.067；95%置信区间 0.006-0.768）。
结论
左旋肉碱的使用可能对预防主动脉瓣手术术后 POAF 有一定作用。
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