Zhang Zixi, Wang Cancan, Liu Qiming, Xiao Yichao, Zhou Jiabao, Wu Keke, Huang Yunying, Zhang Zeying, Liu Shiping, Lin Qiuzhen
Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan Province, People's Republic of China.
Department of Endocrinology, The Second Xiangya Hospital, Central South University, Changsha City, Hunan Province, People's Republic of China.
PLoS One. 2025 Jan 31;20(1):e0317721. doi: 10.1371/journal.pone.0317721. eCollection 2025.
Malnutrition presents a significant challenge in managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), yet its impact on AF recurrence after catheter ablation in this population remains unclear.
We conducted a retrospective analysis of 204 patients with paroxysmal non-valvular AF and HFpEF who underwent radiofrequency or cryoballoon ablation. Risk of malnutrition as assessed using three screening tools: the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI)]. We examined the relationship between risk of malnutrition and AF recurrence post-ablation.
After a mean follow-up period of 11.2 ± 1.8 months, 43 patients (21.1%) experienced AF recurrence. Despite being classified as overweight or obese based on body mass index, many patients were at risk of malnutrition according to the CONUT score, NRI, and PNI. Adjusted analyses showed that higher CONUT scores (HR: 10.132; 95% CI: 2.545-40.336; P = 0.001), lower NRI (HR: 22.734; 95% CI: 6.399-80.776; P < 0.001), or lower PNI (HR: 9.469; 95% CI: 3.232-27.739; P < 0.001) were significantly associated with increased risk of AF recurrence. Restricted cubic spline regression revealed an inverted U-shaped relationship between the CONUT score and AF recurrence, and L-shaped relationships for both NRI and PNI with AF recurrence.
Systematic nutritional assessment is crucial in patients with paroxysmal non-valvular AF and HFpEF. High CONUT scores, low NRI, or low PNI serve as independent predictors for AF recurrence. Further large-scale randomized controlled trials are required to validate these findings.
营养不良在心房颤动（AF）和射血分数保留的心力衰竭（HFpEF）患者的管理中是一项重大挑战，但其对此类人群导管消融术后房颤复发的影响仍不清楚。
我们对204例接受射频或冷冻球囊消融的阵发性非瓣膜性房颤和HFpEF患者进行了回顾性分析。使用三种筛查工具评估营养不良风险：控制营养状况（CONUT）评分、预后营养指数（PNI）和营养风险指数（NRI）。我们研究了营养不良风险与消融术后房颤复发之间的关系。
平均随访11.2±1.8个月后，43例患者（21.1%）出现房颤复发。尽管根据体重指数被归类为超重或肥胖，但根据CONUT评分、NRI和PNI，许多患者仍有营养不良风险。校正分析显示，较高的CONUT评分（HR：10.132；95%CI：2.545 - 40.336；P = 0.001）、较低的NRI（HR：22.734；95%CI：6.399 - 80.776；P < 0.001）或较低的PNI（HR：9.469；95%CI：3.232 - 27.739；P < 0.001）与房颤复发风险增加显著相关。受限立方样条回归显示CONUT评分与房颤复发之间呈倒U形关系，NRI和PNI与房颤复发均呈L形关系。
系统的营养评估对阵发性非瓣膜性房颤和HFpEF患者至关重要。高CONUT评分、低NRI或低PNI是房颤复发的独立预测因素。需要进一步的大规模随机对照试验来验证这些发现
