左心室弥漫性纤维化对持续性心房颤动患者导管消融预后的影响

发布时间：2018-05-25 10:18

本文选题：左心室纤维化 + 心房纤颤　；参考：《首都医科大学》2016年硕士论文

【摘要】：目的:持续性心房颤动(房颤)患者常合并有心室弥漫性心肌纤维化。心室纤维化可引起心室僵硬度增加,与心功能不全密切相关,是心血管疾病不良预后的危险因素。本研究采用心脏核磁共振(CMR)新技术弛豫时间映射图(T1mapping)成像技术对入组人员左心室纤维化程度进行定量分析,探讨左心室纤维化程度对持续房颤患者射频消融预后的影响。方法:32名健康志愿者(10名女性,平均年龄47.7±12.2岁)及80名第一次接受射频消融手术治疗的持续性房颤患者(12名女性,平均年龄55.72±11.3岁)入组本研究并接受3.0T心脏核磁共振检查,测量左心室平均心肌T1值并计算细胞外容积分数(Extracellular volume fraction,ECV)。持续房颤患者均接受房颤导管射频消融(Radiofrequency Catheter Ablation,RFCA)治疗,术后定期随访心律失常复发情况。结果:截至2016年2月,平均随访(8.9±3.1)月。55位患者维持窦性心律,25位患者复发,无死亡。COX回归分析显示ECV大于28.71%(HR 8.185;95.0%CI 1.891-35.431)与左心房前后径(Left ventricle dimension,LAD)(HR 1.056;95.0%CI 1.003-1.096)是RFCA术后房颤复发的独立危险因素。结论:CMR测定左心室ECV增大是持续性房颤患者射频消融术后复发的独立预测因子。
[Abstract]:Objective: persistent atrial fibrillation (AF) is often associated with ventricular diffuse myocardial fibrosis. Ventricular fibrosis can increase the degree of ventricular stiffness and is closely related to cardiac insufficiency. It is a risk factor for poor prognosis of cardiovascular disease. In this study, the degree of left ventricular fibrosis in patients with persistent atrial fibrillation was quantitatively analyzed by cardiac magnetic resonance imaging (CMR) and relaxation time mapping T1mapping.To explore the influence of the degree of left ventricular fibrosis on the prognosis of radiofrequency ablation in patients with persistent atrial fibrillation. Methods Ten women (mean age 47.7 卤12.2 years) from 32 healthy volunteers and 12 women (mean age 55.72 卤11.3 years) from 80 patients with persistent atrial fibrillation who were treated with radiofrequency ablation for the first time were enrolled in the study and underwent 3.0T cardiac magnetic resonance imaging. The mean T 1 value of left ventricle was measured and extracellular volume fractionation (ECV) was calculated. Patients with persistent atrial fibrillation were treated by radiofrequency catheter radiofrequency ablation (RFCA) and the recurrence of arrhythmia was followed up regularly. Results: up to February 2016, 55 patients with sinus arrhythmia were followed up for an average of 8.9 卤3.1 months, with no death. Cox regression analysis showed that ECV was higher than that of 28.71%(HR 8.185 卤95.0 CI 1.891-35.431) and left ventricle dimension LADX HR 1.05695.0CI 1.003-1.096 were independent risk factors for recurrence of atrial fibrillation after RFCA. Conclusion the increase of left ventricular ECV is an independent predictor of recurrence after radiofrequency ablation in patients with persistent atrial fibrillation.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.75

【相似文献】