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新型安特卫普评分在预测亚洲心力衰竭患者房颤消融术后心脏功能改善方面的表现。

Performance of the novel ANTWERP score in predicting heart function improvement after atrial fibrillation ablation in Asian patients with heart failure.

作者信息

Ling Lo-Chieh, Chang Ting-Yung, Lin Yenn-Jiang, Lin Chin-Yu, Chang Shih-Lin, Lo Li-Wei, Hu Yu-Feng, Chung Fa-Po, Chen Shih-Ann

机构信息

Division of Cardiology, Department of Medicine, Heart Rhythm Center Taipei Veterans General Hospital Taipei Taiwan.

Division of Cardiology Taipei Veterans General Hospital Taipei Taiwan.

出版信息

J Arrhythm. 2024 Oct 18;40(6):1359-1369. doi: 10.1002/joa3.13162. eCollection 2024 Dec.

DOI:10.1002/joa3.13162
PMID:39669923
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11632251/
Abstract

BACKGROUND

Previous research has demonstrated that atrial fibrillation (AF) ablation improves heart function variably among patients. We proposed that the ANTWERP score, which was validated in a European group of patients with low left ventricular ejection fraction (LVEF) who had AF ablation, would be valid in an Asian group as well. The purpose of the study is to examine how well a new scoring system (the ANTWERP score) can predict heart function improvement after atrial fibrillation ablation in Asian patients with heart failure.

METHODS

A retrospective review was conducted on patients ( = 84) undergoing AF ablation between January 2019 and June 2022. Initial diagnoses for impaired LV systolic function were confirmed by echocardiography. Patients meeting the "2021 Universal Definition of HF" criteria for LVEF recovery were classified as "responders."

RESULTS

Similarities were observed between responders and nonresponders regarding comorbidities, AF type, and LVEF, except for the left ventricular internal diameter in diastole. A higher percentage of responders had an ANTWERP score ≤2 (87.8%) compared to those with a score >2 (55.6%). LVEF improvement was notably higher in the former group (+14.8% vs. +9.4%,  = .043). Atrial reverse remodeling and recurrent atrial arrhythmia rates were similar across groups.

CONCLUSION

The conclusion of the study was that the ANTWERP score effectively predicted LVEF improvement after atrial fibrillation ablation in the Asian population and that this scoring system could be used to guide clinical decisions and prognosis prediction.

摘要

背景

先前的研究表明,心房颤动(AF)消融术在不同患者中对心脏功能的改善程度有所不同。我们提出,在欧洲一组低左心室射血分数(LVEF)且接受AF消融术的患者中得到验证的安特卫普评分,在亚洲人群中也将有效。本研究的目的是检验一种新的评分系统(安特卫普评分)在预测亚洲心力衰竭患者房颤消融术后心脏功能改善方面的效果如何。

方法

对2019年1月至2022年6月期间接受AF消融术的患者(n = 84)进行回顾性研究。通过超声心动图确认左心室收缩功能受损的初始诊断。符合“2021心力衰竭通用定义”中LVEF恢复标准的患者被归类为“反应者”。

结果

在合并症、房颤类型和LVEF方面,反应者和无反应者之间存在相似之处,但舒张期左心室内径除外。与评分>2的患者(55.6%)相比,评分≤2的反应者比例更高(87.8%)。前一组的LVEF改善明显更高(+14.8%对+9.4%,P = 0.043)。各组间心房逆向重构和复发性房性心律失常发生率相似。

结论

该研究的结论是,安特卫普评分有效地预测了亚洲人群房颤消融术后LVEF的改善,并且该评分系统可用于指导临床决策和预后预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c82/11632251/4a1fa10fdc01/JOA3-40-1359-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c82/11632251/de9473425bd4/JOA3-40-1359-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c82/11632251/975b47124d7d/JOA3-40-1359-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c82/11632251/4a1fa10fdc01/JOA3-40-1359-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c82/11632251/de9473425bd4/JOA3-40-1359-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c82/11632251/975b47124d7d/JOA3-40-1359-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c82/11632251/4a1fa10fdc01/JOA3-40-1359-g002.jpg

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引用本文的文献

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J Arrhythm. 2024 Nov 25;41(1):e13193. doi: 10.1002/joa3.13193. eCollection 2025 Feb.

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2023 ESC Guidelines for the management of cardiomyopathies.2023年欧洲心脏病学会心肌病管理指南。
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Eur Heart J. 2023 Sep 14;44(35):3327-3335. doi: 10.1093/eurheartj/ehad428.
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Catheter Ablation versus Medical Therapy of Atrial Fibrillation in Patients with Heart Failure: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.心力衰竭患者房颤的导管消融与药物治疗:随机对照试验的最新系统评价和荟萃分析
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Catheter ablation of atrial fibrillation in heart failure with impaired systolic function: An updated meta-analysis of randomized controlled trials.收缩功能受损的心力衰竭患者房颤的导管消融:随机对照试验的最新荟萃分析
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A new prediction model for left ventricular systolic function recovery after catheter ablation of atrial fibrillation in patients with heart failure: The ANTWOORD Study.心力衰竭患者心房颤动导管消融后左心室收缩功能恢复的新预测模型:ANTWOORD 研究。
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