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术后QRS时限与左心室舒张末期直径之比作为心脏手术术后房颤风险的预测指标：一项单中心前瞻性研究。

Postoperative QRS duration to left ventricular end-diastolic diameter ratio as a predictor for the risk of postoperative atrial fibrillation in cardiac surgery: A single-center prospective study.

作者信息

Xie Bingxin, Song Wenhua, Yan Yingqun, Korantzopoulos Panagiotis, Tse Gary, Fu Huaying, Qiao Shuai, Han Yongyong, Yuan Meng, Shao Qingmiao, Li Guangping, Chen Tienan, Liu Tong

机构信息

Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.

Department of Cardiovascular Surgery, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.

出版信息

Heliyon. 2024 Jun 28;10(13):e33785. doi: 10.1016/j.heliyon.2024.e33785. eCollection 2024 Jul 15.

DOI:10.1016/j.heliyon.2024.e33785
PMID:39044992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11263650/
Abstract

BACKGROUND AND AIMS

Postoperative atrial fibrillation (POAF) is a frequent complication following cardiac surgery and is associated with adverse clinical outcomes. Our study aimed at determining the clinical and echocardiographic predictors of POAF in patients with cardiac surgery and management of this group of patients may improve their outcome.

METHODS

We prospectively enrolled patients from the department of cardiovascular surgery in the Second Hospital of Tianjin Medical University from October 23, 2020 to October 30, 2022, without a history of atrial fibrillation. Cox regression was used to identify significant predictors of POAF.

RESULTS

A total of 217 patients (79 [36.41 %] were female, 63.96 ± 12.32 years) were included. 88 (40.55 %) patients met the criteria for POAF. Cox regression showed that preoperative left atrial diameter (LAD) (HR: 1.040, 95 % CI 1.008-1.073, p = 0.013) and postoperative QRS/LVEDD (HR: 0.398, 95 % CI 0.193-0.824, p = 0.013) and E/e' (HR: 1.029, 95 % CI 1.002-1.057，p = 0.033) were predictors of POAF.

CONCLUSION

Preoperative LAD and postoperative QRS/LVEDD and E/e' were predictors of POAF in patients undergoing cardiac surgery.

TRIAL REGISTRATION SITE

http://www.chictr.org.cn.

REGISTRATION NUMBER

ChiCTR2200063344.

摘要

背景与目的

术后心房颤动（POAF）是心脏手术后常见的并发症，与不良临床结局相关。我们的研究旨在确定心脏手术患者中POAF的临床和超声心动图预测因素，对这组患者的管理可能会改善其结局。

方法

我们前瞻性纳入了2020年10月23日至2022年10月30日天津医科大学第二医院心血管外科无房颤病史的患者。采用Cox回归分析确定POAF的显著预测因素。

结果

共纳入217例患者（79例[36.41%]为女性，年龄63.96±12.32岁）。88例（40.55%）患者符合POAF标准。Cox回归分析显示，术前左心房直径（LAD）（HR：1.040，95%CI 1.008 - 1.073，p = 0.013）、术后QRS/LVEDD（HR：0.398，95%CI 0.193 - 0.824，p = 0.013）和E/e'（HR：1.029，95%CI 1.002 - 1.057，p = 0.033）是POAF的预测因素。

结论

术前LAD、术后QRS/LVEDD和E/e'是心脏手术患者POAF的预测因素。

试验注册网站

http://www.chictr.org.cn。

注册号

ChiCTR2200063344。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8376/11263650/4acf2e73e4fa/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8376/11263650/9331cac5d5ad/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8376/11263650/6c0fc8427d52/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8376/11263650/4acf2e73e4fa/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8376/11263650/9331cac5d5ad/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8376/11263650/6c0fc8427d52/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8376/11263650/4acf2e73e4fa/gr3.jpg

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J Cardiothorac Surg. 2022 Oct 2;17(1):248. doi: 10.1186/s13019-022-01994-5.
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Predictors and prognostic impact of post-operative atrial fibrillation in patients with hip fracture surgery.
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Predictive Value of QT Interval for Postoperative Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery.QT 间期对非体外循环冠状动脉旁路移植术后心房颤动的预测价值。
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Different Determinants of the Recurrence of Atrial Fibrillation and Adverse Clinical Events in the Mid-Term Period After Atrial Fibrillation Ablation.房颤消融术后中期复发房颤和不良临床事件的不同决定因素。
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