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评估病态肥胖患者接受减重手术后心房颤动预测因素(P 波参数和左心房直径)的变化。

Evaluation of changes in atrial fibrillation predictors(P wave parameters and left atrial diameter) in morbidly obese patients undergoing bariatric surgery.

机构信息

Department of Cardiology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.

Department of Gastroenterology, the Second Affiliated Hospital of Anhui Medical University, China.

出版信息

J Electrocardiol. 2023 May-Jun;78:12-16. doi: 10.1016/j.jelectrocard.2023.01.001. Epub 2023 Jan 9.

Abstract

BACKGROUND

Bariatric surgery has been associated with reduced cardiovascular event in obese patients.In this study, we aimed to investigate the changes between pre-operation and post-operation atrial fibrillation predictors(p-wave parameters and left atrial diameter)in morbidly obese patients who underwent bariatric surgery.

METHODS

176 obese patients undergoing bariatric surgery were enrolled. Heart rate, PR, P-wave max, P-wave min,P-wave dispersion (PWdis), average P-axis, P-wave peak time (PWPT) of lead II and lead V1, terminal force of lead V1 (PWTF V1), partial interatrial block (p-IAB), advanced interatrial block(a-IAB), and left atrial diamete were measured both before operation and 8 months post-operation.

RESULTS

Heart rate, PR, PW max, PW min, PWdis, mean P-axis, PWPT II, PWPT V1, and PWTF V1 were near their upper limits before operation. Left atrial diameter was larger than the upper limit before operation. All parameters showed statistically significant decrease at 8 months post-operation. The most significant changes were observed in PWPT II (55.69 ± 6.87 ms vs 50.43 ± 7.48 ms, p < 0.001), PWPT V1(54.21 ± 7.01 ms vs 48.02 ± 7.13 ms, p < 0.001), PWTF V1(74 [42.0%] vs 41 [23.3%], p < 0.001),p-IAB(41[23.2%]vs11[6.2%],p < 0.001),a-IAB(6[3.4%]vs2[1.1%], p < 0.001), and left atrial diameter(43.25 ± 9.23 mm vs 34.27 ± 6.21 mm,p < 0.001).

CONCLUSIONS

The results of our study showed that bariatric surgery had a positive effect on the regression of P wave parameters and left atrial diameter which are predictors of atrial fibrillation.

摘要

背景

减重手术与肥胖患者心血管事件的减少有关。本研究旨在探讨行减重手术的病态肥胖患者心房颤动预测因子(p 波参数和左心房直径)在术前和术后的变化。

方法

共纳入 176 例行减重手术的肥胖患者。测量手术前后心率、PR 间期、P 波最大时限、P 波最小时限、P 波离散度(PWdis)、平均 P 轴、II 导联和 V1 导联 P 波时限(PWPT)、V1 导联终末电势(PWTF V1)、部分性房内传导阻滞(p-IAB)、完全性房内传导阻滞(a-IAB)和左心房直径。

结果

术前心率、PR 间期、PWmax、PWmin、PWdis、平均 P 轴、PWPT II、PWPT V1 和 PWTF V1 接近上限。左心房直径大于术前上限。所有参数在术后 8 个月均有统计学意义的下降。变化最显著的是 PWPT II(55.69±6.87ms 比 50.43±7.48ms,p<0.001)、PWPT V1(54.21±7.01ms 比 48.02±7.13ms,p<0.001)、PWTF V1(74[42.0%]比 41[23.3%],p<0.001)、p-IAB(41[23.2%]比 11[6.2%],p<0.001)、a-IAB(6[3.4%]比 2[1.1%],p<0.001)和左心房直径(43.25±9.23mm 比 34.27±6.21mm,p<0.001)。

结论

本研究结果表明,减重手术对心房颤动预测因子(p 波参数和左心房直径)的回归有积极作用。

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