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比较 MVP ECG 风险评分等房颤预测因子在单支或双侧内乳动脉使用中的效果。

Efficacy of atrial fibrillation predictors including MVP ECG risk score compared between single or bilateral internal thoracic artery use.

机构信息

Department of Cardiovascular Surgery, Istanbul Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

Department of Cardiology, Istanbul Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

J Cardiothorac Surg. 2024 Aug 2;19(1):479. doi: 10.1186/s13019-024-02926-1.

Abstract

BACKGROUND

Atrial fibrillation (AF) is the most common complication after Coronary Artery Bypass Surgery (CABG). Despite advanced treatment methods, primary prevention is crucial. Many factors have been investigated as markers for AF, but further research is required. CABG is currently superior to Primary Coronary Intervention (PCI) in some cases due to Left Anterior Descending Artery (LAD)- Internal Thoracic Artery (ITA) anastomosis. However, graft choice for non-LAD vessels is still controversial. Our study compared the incidence of arrhythmia between patients with single ITA or bilateral ITA (BITA).

METHODS

The study included 84 isolated CABG patients. The patients were divided into two groups: single ITA and BITA. Patients who developed AF were recorded and compared.

RESULTS

73.8%(n = 62) of the patients were male and 26.2%(n = 22) were female. While single ITA was used in 48.8%(n = 41) of the patients, BITA was used in 51.2%(n = 43). AF was detected in 15.5%(n = 13) of the patients. AF was observed in 5(12.2%) patients in the single ITA group and 8(18.6%) in the BITA group. 76.9%(n = 10) of the patients with AF rhythm had Diabetes Mellitus (DM)(p = 0.011). Biphasic P wave, length of P wave duration, and total Morpholog-Voltage-P Wave ECG (MVP ECG) score height were statistically significantly different.

CONCLUSIONS

The development of AF was similar in both groups. The presence of DM, high blood glucose levels, and ECG findings can detect a predisposition to postoperative AF. MVP ECG risk score is effective as an AF marker and can be used in surgical patient groups.

摘要

背景

心房颤动(AF)是冠状动脉旁路移植术(CABG)后最常见的并发症。尽管有先进的治疗方法,但初级预防至关重要。许多因素已被研究为 AF 的标志物,但仍需要进一步研究。由于左前降支(LAD)-内乳动脉(ITA)吻合术,CABG 在某些情况下目前优于直接经皮冠状动脉介入治疗(PCI)。然而,非 LAD 血管的移植物选择仍存在争议。我们的研究比较了单支 ITA 或双侧 ITA(BITA)患者心律失常的发生率。

方法

该研究纳入 84 例单纯 CABG 患者。患者分为两组:单支 ITA 和 BITA。记录并比较发生 AF 的患者。

结果

73.8%(n=62)的患者为男性,26.2%(n=22)为女性。48.8%(n=41)的患者使用单支 ITA,51.2%(n=43)的患者使用 BITA。15.5%(n=13)的患者检测到 AF。单支 ITA 组有 5 例(12.2%)患者出现 AF,BITA 组有 8 例(18.6%)患者出现 AF。AF 节律患者中 76.9%(n=10)患有糖尿病(DM)(p=0.011)。双相 P 波、P 波持续时间和总形态-电压-P 波心电图(MVP ECG)评分高度均有统计学差异。

结论

两组 AF 的发生情况相似。DM、高血糖水平和心电图发现可检测到术后 AF 的易感性。MVP ECG 风险评分是一种有效的 AF 标志物,可用于手术患者群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fb7/11295644/90f8c93e212f/13019_2024_2926_Fig1_HTML.jpg

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