{"title":"左心房机械弥散和左心房僵硬度可预测心房颤动的复发:中重度风湿性二尖瓣狭窄患者。","authors":"","doi":"10.1016/j.ijcard.2024.132480","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><p>The aim of this study was to evaluate the relationship between preoperative left atrial function and recurrence of atrial fibrillation (AF) after mitral valve surgery and Cox Maze procedure in patients with moderate-to-severe rheumatic mitral stenosis (MS) combined with AF, in order to facilitate clinical risk stratification and to guide treatment strategies.</p></div><div><h3>Methods and results</h3><p>Patients with moderate-to-severe rheumatic MS attending Beijing Anzhen Hospital of Capital Medical University from April 2022 to September 2023 were prospectively collected, and all of them underwent transthoracic two-dimensional speckle-tracking echocardiography to assess left atrial structure and function before undergoing mitral valve surgery and Cox Maze procedure and postoperative follow-up. 121 patients were enrolled, of whom 77.69 % (94/121) were female, with a median follow-up time of 9.56 ± 1.83 months, and 48 patients (39.7 %, 48/121) had postoperative recurrence of AF. Preoperative left atrial stiffness index (LASI) [3.76(3.10–5.44) vs. 2.41(1.75–3.33), <em>P < 0.001</em>] and left atrial mechanical dispersion (SD-TPS) (15.84 ± 5.92vs. 11.58 ± 5.96, <em>P = 0.001</em>) were significantly higher in the postoperative AF recurrence group than in the without recurrence group; Multivariable cox regression analysis showed that LASI>3.15 and SD -TPS > 13.2 were associated with independent risk factors for AF recurrence (hazard ratio = 2.957, 95 %CI,1.366–6.399, <em>P = 0.006</em> and hazard ratio = 2.892, 95 %CI,1.381–6.057, <em>P = 0.005</em>).</p></div><div><h3>Conclusion</h3><p>LASI and SD-TPS were effective predictors of postoperative recurrence of AF in patients with moderate-to-severe rheumatic MS, and LASI >3.15 and SD-TPS% >13.2 were independent influences on the recurrence of AF after Cox Maze in this group of patients.</p></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Left atrial mechanical dispersion and left atrial stiffness predicts recurrence of atrial fibrillation: In patients with moderate-severe rheumatic mitral stenosis\",\"authors\":\"\",\"doi\":\"10.1016/j.ijcard.2024.132480\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><p>The aim of this study was to evaluate the relationship between preoperative left atrial function and recurrence of atrial fibrillation (AF) after mitral valve surgery and Cox Maze procedure in patients with moderate-to-severe rheumatic mitral stenosis (MS) combined with AF, in order to facilitate clinical risk stratification and to guide treatment strategies.</p></div><div><h3>Methods and results</h3><p>Patients with moderate-to-severe rheumatic MS attending Beijing Anzhen Hospital of Capital Medical University from April 2022 to September 2023 were prospectively collected, and all of them underwent transthoracic two-dimensional speckle-tracking echocardiography to assess left atrial structure and function before undergoing mitral valve surgery and Cox Maze procedure and postoperative follow-up. 121 patients were enrolled, of whom 77.69 % (94/121) were female, with a median follow-up time of 9.56 ± 1.83 months, and 48 patients (39.7 %, 48/121) had postoperative recurrence of AF. Preoperative left atrial stiffness index (LASI) [3.76(3.10–5.44) vs. 2.41(1.75–3.33), <em>P < 0.001</em>] and left atrial mechanical dispersion (SD-TPS) (15.84 ± 5.92vs. 11.58 ± 5.96, <em>P = 0.001</em>) were significantly higher in the postoperative AF recurrence group than in the without recurrence group; Multivariable cox regression analysis showed that LASI>3.15 and SD -TPS > 13.2 were associated with independent risk factors for AF recurrence (hazard ratio = 2.957, 95 %CI,1.366–6.399, <em>P = 0.006</em> and hazard ratio = 2.892, 95 %CI,1.381–6.057, <em>P = 0.005</em>).</p></div><div><h3>Conclusion</h3><p>LASI and SD-TPS were effective predictors of postoperative recurrence of AF in patients with moderate-to-severe rheumatic MS, and LASI >3.15 and SD-TPS% >13.2 were independent influences on the recurrence of AF after Cox Maze in this group of patients.</p></div>\",\"PeriodicalId\":13710,\"journal\":{\"name\":\"International journal of cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-08-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0167527324011021\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167527324011021","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的:本研究旨在评估中重度风湿性二尖瓣狭窄合并房颤患者术前左房功能与二尖瓣手术及Cox Maze术后房颤复发的关系,以促进临床风险分层,指导治疗策略:前瞻性收集2022年4月至2023年9月在首都医科大学附属北京安贞医院就诊的中重度风湿性二尖瓣狭窄患者,所有患者在接受二尖瓣手术和Cox Maze术前均接受经胸二维斑点追踪超声心动图评估左房结构和功能,并进行术后随访。121名患者入选,其中77.69%(94/121)为女性,中位随访时间为(9.56±1.83)个月,48名患者(39.7%,48/121)术后房颤复发。术前左房僵硬度指数(LASI)[3.76(3.10-5.44) vs. 2.41(1.75-3.33), P 3.15]和 SD-TPS > 13.2与房颤复发的独立危险因素相关(危险比 = 2.957, 95 %CI,1.366-6.399, P = 0.006 和危险比 = 2.892, 95 %CI,1.381-6.057, P = 0.005):LASI和SD-TPS是中重度风湿性多发性硬化症患者术后房颤复发的有效预测指标,LASI>3.15和SD-TPS%>13.2是该组患者在Cox迷宫术后房颤复发的独立影响因素。
Left atrial mechanical dispersion and left atrial stiffness predicts recurrence of atrial fibrillation: In patients with moderate-severe rheumatic mitral stenosis
Aims
The aim of this study was to evaluate the relationship between preoperative left atrial function and recurrence of atrial fibrillation (AF) after mitral valve surgery and Cox Maze procedure in patients with moderate-to-severe rheumatic mitral stenosis (MS) combined with AF, in order to facilitate clinical risk stratification and to guide treatment strategies.
Methods and results
Patients with moderate-to-severe rheumatic MS attending Beijing Anzhen Hospital of Capital Medical University from April 2022 to September 2023 were prospectively collected, and all of them underwent transthoracic two-dimensional speckle-tracking echocardiography to assess left atrial structure and function before undergoing mitral valve surgery and Cox Maze procedure and postoperative follow-up. 121 patients were enrolled, of whom 77.69 % (94/121) were female, with a median follow-up time of 9.56 ± 1.83 months, and 48 patients (39.7 %, 48/121) had postoperative recurrence of AF. Preoperative left atrial stiffness index (LASI) [3.76(3.10–5.44) vs. 2.41(1.75–3.33), P < 0.001] and left atrial mechanical dispersion (SD-TPS) (15.84 ± 5.92vs. 11.58 ± 5.96, P = 0.001) were significantly higher in the postoperative AF recurrence group than in the without recurrence group; Multivariable cox regression analysis showed that LASI>3.15 and SD -TPS > 13.2 were associated with independent risk factors for AF recurrence (hazard ratio = 2.957, 95 %CI,1.366–6.399, P = 0.006 and hazard ratio = 2.892, 95 %CI,1.381–6.057, P = 0.005).
Conclusion
LASI and SD-TPS were effective predictors of postoperative recurrence of AF in patients with moderate-to-severe rheumatic MS, and LASI >3.15 and SD-TPS% >13.2 were independent influences on the recurrence of AF after Cox Maze in this group of patients.
期刊介绍:
The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers.
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