Relationship between CT quantitative left heart structure parameters and recurrence of hypertrophic cardiomyopathy complicated with atrial fibrillation after radiofrequency ablation

doi:10.11958/20242189

Abstract

Abstract:

Objective To explore the relationship between CT quantitative left heart structure parameters and recurrence after hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF) radiofrequency ablation (RFCA). Methods A total of 120 patients with HCM and AF admitted to our hospital from April 2021 to June 2023 were selected. Patients were divided into the relapse group and the non-recurrence group according to whether RFCA recurred 6 months after operation. All patients underwent CT examination, and left ventricular ejection fraction (LVEF), left atrial ejection fraction (LAEF), left atrial volume index (LAVI) and left atrial auricular volume of the two groups were analyzed. The clinical data of patients were collected. Logistic regression model was used to analyze the influencing factors of postoperative recurrence of RFCA in HCM patients with AF. Receiver operating characteristic curve (ROC) curve was used to analyze the predictive efficacy of left heart structure parameters for postoperative recurrence of RFCA in HCM patients with AF. Results The volume levels of LAVI and left auricle were higher in the relapsed group than those in the non-relapsed group, and the level of LAEF was lower than those in the non-relapsed group (P<0.05). Logistic regression analysis showed that persistent atrial fibrillation, LAVI and high left atrial appendage volume were independent risk factors for postoperative recurrence in HCM patients with AF (P<0.05), and high LAEF was protective factor (P<0.05). The results of ROC curve analysis showed that the AUC value of LAVI, LAEF and left atrial appendage volume in predicting recurrence after RFCA in patients with HCM and AF was 0.902, which was higher than that of 0.789, 0.755 and 0.675 of each individual test. The combined prediction efficiency of the three tests was higher than that of each single test (Z=2.177, 2.555 and 3.628, P<0.05). Conclusion High level of LAVI and left atrial appendage volume and low level of LAEF are risk factors for postoperative recurrence of RFCA. The combined detection of the three methods has high predictive value for postoperative recurrence of RFCA in HCM patients with AF.

Key words: cardiomyopathy, hypertrophic, atrial fibrillation, radiofrequency ablation, tomography, spiral computed, ejection fraction, left atrial volume index, left atrial appendage volume

CLC Number:

R542.2

Figures/Tables 5

References 20

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组别	n	性别		年龄/岁	BMI/（kg/m²）	AF病程/月	房颤类型		合并症			吸烟史
组别	n	男	女	年龄/岁	BMI/（kg/m²）	AF病程/月	持续性	阵发性	高血压	糖尿病	高脂血症	吸烟史
未复发组	79	46（58.2）	33（41.8）	55.76±8.27	23.21±1.74	32.49±4.83	21（26.6）	58（73.4）	35（44.3）	11（13.9）	20（25.3）	25（31.7）
复发组	41	26（63.4）	15（36.6）	57.07±8.84	23.47±1.69	34.73±5.14	22（53.7）	19（46.3）	24（58.5）	9（22.0）	14（34.2）	16（39.0）
t或χ²		0.303		0.799	0.776	2.333^＊	8.606^＊＊		2.188	1.252	1.036	0.653
组别			饮酒史	卒中史	心功能分级			手术时间/min	抗凝药	抗心律失常药		抗血小板聚集药
组别			饮酒史	卒中史	Ⅱ级	Ⅲ级	Ⅳ级	手术时间/min	抗凝药	抗心律失常药		抗血小板聚集药
未复发组			18（22.8）	3（3.8）	25（31.7）	46（58.2）	8（10.1）	165.34±42.87	32（40.5）	25（31.7）		25（31.7）
复发组			13（31.7）	4（9.7）	15（36.6）	16（39.0）	10（24.4）	152.88±41.44	18（43.9）	14（34.2）		15（36.6）
t或χ²			1.122	1.745	5.785			1.515	0.128	0.077		0.296

组别	n	性别		年龄/岁	BMI/（kg/m²）	AF病程/月	房颤类型		合并症			吸烟史
组别	n	男	女	年龄/岁	BMI/（kg/m²）	AF病程/月	持续性	阵发性	高血压	糖尿病	高脂血症	吸烟史
未复发组	79	46（58.2）	33（41.8）	55.76±8.27	23.21±1.74	32.49±4.83	21（26.6）	58（73.4）	35（44.3）	11（13.9）	20（25.3）	25（31.7）
复发组	41	26（63.4）	15（36.6）	57.07±8.84	23.47±1.69	34.73±5.14	22（53.7）	19（46.3）	24（58.5）	9（22.0）	14（34.2）	16（39.0）
t或χ²		0.303		0.799	0.776	2.333^＊	8.606^＊＊		2.188	1.252	1.036	0.653
组别			饮酒史	卒中史	心功能分级			手术时间/min	抗凝药	抗心律失常药		抗血小板聚集药
组别			饮酒史	卒中史	Ⅱ级	Ⅲ级	Ⅳ级	手术时间/min	抗凝药	抗心律失常药		抗血小板聚集药
未复发组			18（22.8）	3（3.8）	25（31.7）	46（58.2）	8（10.1）	165.34±42.87	32（40.5）	25（31.7）		25（31.7）
复发组			13（31.7）	4（9.7）	15（36.6）	16（39.0）	10（24.4）	152.88±41.44	18（43.9）	14（34.2）		15（36.6）
t或χ²			1.122	1.745	5.785			1.515	0.128	0.077		0.296

组别	n	LAVI/ （mL/m²）	LVEF	LAEF	左心耳体积/mL
未复发组	79	30.12±8.21	0.685 9±0.063 1	0.539 6±0.124 5	8.87±2.17
复发组	41	39.45±9.87	0.664 1±0.070 9	0.327 6±0.082 6	15.72±3.14
t		5.498^＊＊	1.720	9.828^＊＊	14.051^＊＊

组别	n	LAVI/ （mL/m²）	LVEF	LAEF	左心耳体积/mL
未复发组	79	30.12±8.21	0.685 9±0.063 1	0.539 6±0.124 5	8.87±2.17
复发组	41	39.45±9.87	0.664 1±0.070 9	0.327 6±0.082 6	15.72±3.14
t		5.498^＊＊	1.720	9.828^＊＊	14.051^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
AF病程	0.732	0.378	3.750	0.097	2.079	0.991~4.362
房颤类型	0.628	0.262	5.745	<0.001	1.874	1.121~3.132
LAVI	0.802	0.343	5.467	<0.001	2.230	1.139~4.368
LAEF	-0.591	0.275	4.619	0.013	0.554	0.323~0.949
左心耳体积	0.732	0.257	5.041	<0.001	1.781	1.706~2.947
常数项	-0.094	0.046	4.176	<0.001	<0.001