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二尖瓣环平面收缩期位移(MAPSE)可预测冠状动脉旁路手术后心房颤动的发生。

Mitral annular plane systolic excursion (MAPSE) as a predictor of atrial fibrillation development after coronary artery bypass surgery.

出版信息

Bratisl Lek Listy. 2024;125(8):503-507. doi: 10.4149/BLL_2024_78.

Abstract

OBJECTIVE

To predict the possibility of postoperative atrial fibrillation (AF) with mitral annular plane systolic excursion (MAPSE) measurement, which is a cheap, reproducible echocardiographic method and to monitor these patients more closely and to evaluate them more effectively postoperatively.

MATERIAL AND METHODS

247 patients scheduled for coronary artery bypass surgery were evaluated and 200 patients were included in the study.The enrolled patients were classified into the two groups according to the occurrence of postoperative AF or maintained sinus rhythm after coronary artery bypass surgery (normal sinus rhythm [NSR] group vs. AF group).The clinical and demographic data of all the patients were recorded on admission. Two-dimensional transthoracic echocardiography (TTE) was performed prior to elective surgery.

RESULTS

Postoperative new onset AF occurred in 37 (18.5%) patients. In the multivariate logistic regression analysis carried out after the formation of the model based on the parameters related to AF development, the relationships with white blood cell count, LAd and MAPSE were observed to be prevalent.When MAPSE, which is a parameter used to predict the development of postoperative atrial fibrillation, was compared in the ROC analysis, the area under the curve was found to be 0.831, 95% CI lower-95% CI upper (0.761-0.901) (p<0.001).The distinguishing MAPSE value in predicting postoperative atrial fibrillation development was found to be 11.6 (sensitivity: 90%, specificity: 81%).

CONCLUSIONS

We showed that MAPSE could play a role in determining postoperative atrial fibrillation development after coronary artery bypass surgery (Tab. 2, Fig. 2, Ref. 28).

摘要

目的

利用二尖瓣环平面收缩期位移(MAPSE)测量来预测术后心房颤动(AF)的可能性,这是一种廉价、可重复的超声心动图方法,可以更密切地监测这些患者,并在术后更有效地评估他们。

材料和方法

评估了 247 名拟行冠状动脉旁路移植术的患者,其中 200 名患者纳入研究。根据术后 AF 的发生或冠状动脉旁路移植术后是否维持窦性心律(正常窦性节律[NSR]组与 AF 组),将纳入的患者分为两组。记录所有患者入院时的临床和人口统计学数据。所有患者均在择期手术前行二维经胸超声心动图(TTE)检查。

结果

37 例(18.5%)患者术后新发 AF。在基于与 AF 发生相关的参数建立模型后进行的多变量逻辑回归分析中,观察到与白细胞计数、LAd 和 MAPSE 的关系普遍存在。当比较用于预测术后心房颤动发生的 MAPSE 等参数时,ROC 分析发现曲线下面积为 0.831,95%CI 下限-95%CI 上限(0.761-0.901)(p<0.001)。预测术后心房颤动发生的区分 MAPSE 值为 11.6(敏感性:90%,特异性:81%)。

结论

我们表明,MAPSE 可在确定冠状动脉旁路移植术后 AF 发生方面发挥作用(表 2、图 2、参考文献 28)。

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