Peguero-Lo-Presti指数诊断的左心室肥厚与阵发性心房颤动射频导管消融术后复发的关系

doi:10.11958/20230627

天津医药 ›› 2024, Vol. 52 ›› Issue (2): 210-214.doi: 10.11958/20230627

Peguero-Lo-Presti指数诊断的左心室肥厚与阵发性心房颤动射频导管消融术后复发的关系

张明龙¹(), 方媛媛¹, 隋晓鹏¹, 陈欣欣¹, 李留东², 王海涛¹^,^△()

1.中国人民解放军联勤保障部队第九七〇医院心内科（邮编264010）
2.烟台毓璜顶医院心内科

收稿日期:2023-04-24 修回日期:2023-05-15 出版日期:2024-02-15 发布日期:2024-01-26
通讯作者: ^△ E-mail：wht107@163.com
作者简介:张明龙（1988），男，主治医师，主要从事冠心病和心律失常介入方面研究。E-mail：zhangminglong2020@163.com

Relationship between left ventricular hypertrophy diagnosed by Peguero-Lo-Presti index and recurrence after radiofrequency catheter ablation of paroxysmal atrial fibrillation

ZHANG Minglong¹(), FANG Yuanyuan¹, SUI Xiaopeng¹, CHEN Xinxin¹, LI Liudong², WANG Haitao¹^,^△()

1. Department of Cardiology, 970 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army, Yantai 264010, China
2. Department of Cardiology, Yantai Yuhuangding Hospital

Received:2023-04-24 Revised:2023-05-15 Published:2024-02-15 Online:2024-01-26
Contact: ^△ E-mail: wht107@163.com

张明龙, 方媛媛, 隋晓鹏, 陈欣欣, 李留东, 王海涛. Peguero-Lo-Presti指数诊断的左心室肥厚与阵发性心房颤动射频导管消融术后复发的关系[J]. 天津医药, 2024, 52(2): 210-214.

ZHANG Minglong, FANG Yuanyuan, SUI Xiaopeng, CHEN Xinxin, LI Liudong, WANG Haitao. Relationship between left ventricular hypertrophy diagnosed by Peguero-Lo-Presti index and recurrence after radiofrequency catheter ablation of paroxysmal atrial fibrillation[J]. Tianjin Medical Journal, 2024, 52(2): 210-214.

摘要/Abstract

摘要：

目的探讨Peguero-Lo-Presti指数诊断的左心室肥厚（LVH）与阵发性心房颤动（房颤）射频消融术后复发的关系。方法选取成功接受射频导管消融的阵发性房颤患者652例。根据Peguero-Lo-Presti指数分为LVH组（167例）和左心室正常（LVN）组（485例）。收集患者的基线资料，在射频导管消融术后3、6、12个月以及此后每12个月间隔进行规律随访，评估有无房颤复发；采用Kaplan-Meier法绘制2组的房颤复发曲线；Cox比例风险模型评估房颤复发的影响因素。结果中位随访时间为20.5（15.0，26.0）个月，共155例（23.8%）患者出现复发，LVH组95例，LVN组60例，LVH组的无房颤复发率明显低于LVN组（64.1% vs. 80.4%，Log-rank χ²=26.361，P<0.01）。校正年龄、性别、体质量指数、高血压、糖尿病、冠心病、心功能不全、左房前后径、左室舒张末期内径和左室射血分数后，Peguero-Lo-Presti指数诊断的LVH仍是房颤复发的危险因素[HR（95%CI）：2.359（1.663~3.345），P<0.01]。结论 Peguero-Lo-Presti指数诊断的LVH是阵发性房颤患者射频导管消融术后复发的危险因素。

关键词: 肥大, 左心室, 心房颤动, 射频消融术, 复发, Peguero-Lo-Presti指数

Abstract:

Objective To investigate the relationship between left ventricular hypertrophy (LVH) diagnosed by Peguero-Lo-Presti index and recurrence of paroxysmal atrial fibrillation (AF) after radiofrequency ablation. Methods A total of 652 patients with paroxysmal atrial fibrillation who underwent radiofrequency ablation were selected. According to Peguero-Lo-Presti index, patients were divided into the LVH group (167 cases) and the normal left ventricle group (485 cases). Baseline data were collected, and regular follow-up was performed at 3, 6 and 12 months after radiofrequency catheter ablation. The recurrence of AF was assessed. Kaplan-Meier survival curve was used to analyze the recurrence rate of AF in the two groups. Cox proportional hazard model was used to assess risk factors for recurrent atrial fibrillation. Results The median follow-up time was 20.5 (15.0, 26.0) months. A total of 155 patients (23.8%) developed recurrence of AF, including 95 patients in the LVH group and 60 patients in the LVN group. The recurrence rate without AF was significantly lower in the LVH group than that in the LVN group (64.1% vs. 80.4%, Log-rank χ²=26.361, P<0.01). After adjusting for age, sex, body mass index, hypertension, diabetes, coronary heart disease, cardiac dysfunction, left anteroposterior and posterior atrial diameter, left ventricular end-diastolic diameter, and left ventricular ejection fraction, LVH diagnosed by Peguero-Lo-Presti index was still a risk factor for recurrent AF [HR (95%CI) : 2.359 (1.663-3.345), P<0.01]. Conclusion In patients with paroxysmal AF, LVH diagnosed by Peguero-Lo-Presti index is a risk factor of AF recurrence after radiofrequency catheter ablation.

Key words: hypertrophy, left ventricular, atrial fibrillation, radiofrequency ablation, recurrence, Peguero-Lo-Presti index

中图分类号:

R541.75

图/表 3

参考文献 29

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组别	n			年龄/岁				男性		BMI/（kg/m²）					高血压
LVN组	485			58.9±9.90				340（70.1）		25.9±3.56					277（57.1）
LVH组	167			59.7±9.93				94（56.3）		26.0±3.50					110（65.9）
t或χ²				0.893				10.040^＊＊		0.136					3.592
组别		糖尿病				冠心病			心功能不全				外周血管疾病
LVN组		99（20.4）				116（23.9）			64（13.2）				120（24.7）
LVH组		46（27.5）				53（31.7）			33（19.8）				43（25.7）
χ²		3.254				3.559			3.725				0.024
组别			卒中/TIA				NT-proBNP/（ng/L）				LAD/mm			LVEDD/mm
LVN组			85（17.5）				140.4（49.6，397.9）				39.0±5.18			47.2±4.86
LVH组			35（21.0）				228.4（55.0，756.7）				40.0±5.39			48.9±4.64
t、χ²或Z			0.759				2.755^＊＊				2.259^＊			4.116^＊＊
组别		LVEF			CHA₂DS₂-VASc评分/分							HASBLED评分/分
LVN组		0.63±0.05			2（1，3）							1（1，2）
LVH组		0.64±0.05			2（1，4）							2（1，2）
t或χ²		2.061^＊			0.144							1.007

组别	n			年龄/岁				男性		BMI/（kg/m²）					高血压
LVN组	485			58.9±9.90				340（70.1）		25.9±3.56					277（57.1）
LVH组	167			59.7±9.93				94（56.3）		26.0±3.50					110（65.9）
t或χ²				0.893				10.040^＊＊		0.136					3.592
组别		糖尿病				冠心病			心功能不全				外周血管疾病
LVN组		99（20.4）				116（23.9）			64（13.2）				120（24.7）
LVH组		46（27.5）				53（31.7）			33（19.8）				43（25.7）
χ²		3.254				3.559			3.725				0.024
组别			卒中/TIA				NT-proBNP/（ng/L）				LAD/mm			LVEDD/mm
LVN组			85（17.5）				140.4（49.6，397.9）				39.0±5.18			47.2±4.86
LVH组			35（21.0）				228.4（55.0，756.7）				40.0±5.39			48.9±4.64
t、χ²或Z			0.759				2.755^＊＊				2.259^＊			4.116^＊＊
组别		LVEF			CHA₂DS₂-VASc评分/分							HASBLED评分/分
LVN组		0.63±0.05			2（1，3）							1（1，2）
LVH组		0.64±0.05			2（1，4）							2（1，2）
t或χ²		2.061^＊			0.144							1.007

因素	β	SE	Wald χ²	P	HR（95% CI）
未校正	0.821	0.166	24.376	<0.001	2.288（1.652~3.169）
模型一	0.837	0.170	25.292	<0.001	2.328（1.670~3.247）
模型二	0.836	0.173	26.131	<0.001	2.329（1.661~3.265）
模型三	0.848	0.178	33.213	<0.001	2.359（1.663~3.345）

因素	β	SE	Wald χ²	P	HR（95% CI）
未校正	0.821	0.166	24.376	<0.001	2.288（1.652~3.169）
模型一	0.837	0.170	25.292	<0.001	2.328（1.670~3.247）
模型二	0.836	0.173	26.131	<0.001	2.329（1.661~3.265）
模型三	0.848	0.178	33.213	<0.001	2.359（1.663~3.345）

Peguero-Lo-Presti指数诊断的左心室肥厚与阵发性心房颤动射频导管消融术后复发的关系

Relationship between left ventricular hypertrophy diagnosed by Peguero-Lo-Presti index and recurrence after radiofrequency catheter ablation of paroxysmal atrial fibrillation

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