合并症对因心房颤动行经皮冷冻球囊肺静脉隔离术患者肺功能(通过肺活量测定法测量)的影响

The Impact of Comorbidities on Pulmonary Function Measured by Spirometry in Patients After Percutaneous Cryoballoon Pulmonary Vein Isolation Due to Atrial Fibrillation.

作者信息

Różycka-Kosmalska Monika, Kosmalski Marcin, Panek Michał, Majos Alicja, Szymczak-Pajor Izabela, Śliwińska Agnieszka, Kasznicki Jacek, Wranicz Jerzy Krzysztof, Kaczmarek Krzysztof

机构信息

Department of Electrocardiology, Medical University of Lodz, 92-213 Lodz, Poland.

Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland.

出版信息

J Clin Med. 2025 Aug 1;14(15):5431. doi: 10.3390/jcm14155431.

Abstract

Pulmonary vein isolation (PVI) via cryoballoon ablation (CBA) is a recommended therapeutic strategy for patients with symptomatic paroxysmal and persistent atrial fibrillation (AF) who are refractory to antiarrhythmic drugs. Although PVI has demonstrated efficacy in reducing AF recurrence and improving patients' quality of life, its impact on respiratory function is not well understood, particularly in patients with comorbid conditions. The aim of the study was to search for functional predictors of the respiratory system in the process of evaluating the efficiency of clinical assessment of CBA in patients with AF. We conducted a prospective study on 42 patients with symptomatic AF who underwent CBA, assessing their respiratory function through spirometry before and 30 days after the procedure. Exclusion criteria included pre-existing lung disease and cardiac insufficiency. The impact of variables such as body mass index (BMI), coronary artery disease (CAD) and heart failure (HF) on spirometry parameters was analyzed using statistical tests. No significant changes were observed in overall post-PVI spirometry parameters for the full cohort. However, post hoc analyses revealed a significant decline in ΔMEF in patients with CAD and BMI ≥ 30 kg/m, whereas ΔFEV/FVCex was significantly increased in patients with HF, as well as in patients with ejection fraction (EF) < 50%. CBA for AF does not universally affect respiratory function in the short term, but specific subgroups, including patients with CAD and a higher BMI, may require post-procedure respiratory monitoring. In addition, PVI may improve lung function in patients with HF and reduced EF.

摘要

通过冷冻球囊消融术(CBA)进行肺静脉隔离(PVI)是对阵发性和持续性症状性心房颤动(AF)且对抗心律失常药物难治的患者推荐的治疗策略。尽管PVI已证明在减少房颤复发和改善患者生活质量方面有效,但其对呼吸功能的影响尚未完全了解,尤其是在合并其他疾病的患者中。本研究的目的是在评估房颤患者CBA临床评估效率的过程中寻找呼吸系统的功能预测指标。我们对42例接受CBA的症状性房颤患者进行了一项前瞻性研究,在手术前和术后30天通过肺活量测定法评估他们的呼吸功能。排除标准包括既往存在的肺部疾病和心脏功能不全。使用统计检验分析体重指数(BMI)、冠状动脉疾病(CAD)和心力衰竭(HF)等变量对肺活量测定参数的影响。整个队列在PVI术后肺活量测定参数方面未观察到显著变化。然而,事后分析显示,CAD患者且BMI≥30 kg/m²的患者ΔMEF显著下降,而HF患者以及射血分数(EF)<50%的患者ΔFEV₁/FVC显著增加。房颤的CBA在短期内并非普遍影响呼吸功能,但特定亚组,包括CAD患者和较高BMI患者,术后可能需要进行呼吸监测。此外,PVI可能改善HF患者和EF降低患者的肺功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4124/12347115/612bb3d9ee20/jcm-14-05431-g001.jpg

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