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单中心 575 例患者经导管消融术后测定血清超敏甲状腺刺激激素水平预测心房颤动复发风险

Measurement of Serum Ultra-Sensitive Thyroid-Stimulating Hormone Levels to Determine the Risk for Recurrence of Atrial Fibrillation Following Catheter Ablation in 575 Patients from a Single Center.

机构信息

Department of Cardiology, Beijing Ditan Hospital, Capital Medical University, Beijing, China (mainland).

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland).

出版信息

Med Sci Monit. 2023 Apr 22;29:e937958. doi: 10.12659/MSM.937958.

Abstract

BACKGROUND Thyroid dysfunction has been proved to contribute to the occurrence of atrial fibrillation (AF), leading to the development of AF in animal models and clinical populations. This single-center study investigated the relationship between ultra-sensitive thyroid-stimulating hormone (uTSH) levels and the recurrence of atrial fibrillation (AF) in 575 hospitalized patients who had undergone catheter ablation. MATERIAL AND METHODS The study enrolled 575 hospitalized patients with AF who needed catheter ablation, 105 were non-first catheter ablation patients, and 470 were first catheter ablation (CA) patients. Before ablation, fasting biochemical indexes, including uTSH, were detected. Patients were classified according to uTSH quartile. The presence of AF was confirmed by 12-lead electrocardiogram or 24-h ambulatory electrocardiogram. RESULTS A total of 105 (18.44%) patients had undergone catheter ablation of AF twice or more. Univariate logistic regression analysis showed no significant relationship between uTSH and AF recurrence (HR, 1.047; 95% CI 0.986-1.111; P=1.127). Multivariate logistic regression analysis indicated that compared with low quartiles (Q1 OR, 0.71, 95% CI: 0.35-1.46; P=0.36; Q2 OR 0.71, 95% CI 0.36-1.39; P=0.31;Q3 OR 0.22, 95% CI 0.09-0.53; P=0.001), high quartiles of uTSH had a higher risk of AF recurrence. After adjusting for sex, the risk of AF recurrence in the high quartile uTSH was higher in males than in the low quartile (Q1 OR, 0.60, 95% CI: 0.29-1.26; P=0.18;Q2 OR, 0.52, 95% CI, 0.24-1.13; P=0.09;Q3 OR, 0.42, 95% CI, 0.18-0.94; P=0.03), but not in women. CONCLUSIONS Serum TSH levels in male patients treated for AF with cardiac ablation were significantly associated with AF recurrence.

摘要

背景

甲状腺功能障碍已被证明可导致心房颤动(AF)的发生,导致动物模型和临床人群中出现 AF。这项单中心研究调查了超敏促甲状腺激素(uTSH)水平与 575 名因心房颤动(AF)而住院并接受导管消融的患者的 AF 复发之间的关系。

材料和方法

该研究纳入了 575 名因 AF 需要导管消融的住院患者,其中 105 名患者为非首次导管消融患者,470 名患者为首次导管消融(CA)患者。在消融前,检测空腹生化指标,包括 uTSH。根据 uTSH 四分位数对患者进行分类。通过 12 导联心电图或 24 小时动态心电图确认 AF 的存在。

结果

共有 105 名(18.44%)患者进行了两次或更多次 AF 的导管消融。单变量逻辑回归分析显示,uTSH 与 AF 复发无显著相关性(HR,1.047;95%CI,0.986-1.111;P=1.127)。多变量逻辑回归分析表明,与低四分位数(Q1,OR,0.71,95%CI:0.35-1.46;P=0.36;Q2,OR,0.71,95%CI,0.36-1.39;P=0.31;Q3,OR,0.22,95%CI,0.09-0.53;P=0.001)相比,高四分位数的 uTSH 有更高的 AF 复发风险。在调整性别后,高四分位数 uTSH 的 AF 复发风险在男性中高于低四分位数(Q1,OR,0.60,95%CI:0.29-1.26;P=0.18;Q2,OR,0.52,95%CI,0.24-1.13;P=0.09;Q3,OR,0.42,95%CI,0.18-0.94;P=0.03),但在女性中则不然。

结论

接受心脏消融治疗的 AF 男性患者的血清 TSH 水平与 AF 复发显著相关。

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