{"title":"基于血液动力学参数,开发并验证非瓣膜性心房颤动患者导管消融术后心房颤动复发的预测模型。","authors":"Decai Zeng, Shuai Chang, Xiaofeng Zhang, Yanfen Zhong, Yongzhi Cai, Tongtong Huang, Ji Wu","doi":"10.1016/j.hrthm.2024.08.058","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The influence of hemodynamic parameters on the recurrence of atrial fibrillation (AF) following catheter ablation is not well known, and it remains unclear whether a nomogram combining risk factors and hemodynamic parameters improves prediction accuracy.</p><p><strong>Objective: </strong>This study aimed to develop a nomogram based on echocardiographic hemodynamic parameters for predicting AF recurrence following catheter ablation in non-valvular atrial fibrillation (NVAF).</p><p><strong>Methods: </strong>A total of 380 consecutive NVAF patients undergoing AF catheter ablation treatment were prospectively collected. Patients were divided into training and validation cohorts at a 7:3 ratio. The follow-up duration averaged 9 months with a median of 12 months, during which 132 patients (34.7%) experienced a recurrence of AF.</p><p><strong>Results: </strong>LASSO regression and Cox regression analyses identified four significant predictors of AF recurrence: persistent AF (HR=1.63, 95% CI=1.02∼2.61, P=0.041), the systolic/diastolic (S/D) ratio (HR=0.50, 95% CI=0.30∼0.84, P=0.009), left atrial acceleration factor α (HR=1.31, 95% CI=1.02∼1.68, P=0.032), and left atrial appendage peak emptying flow velocity (HR=0.98, 95% CI=0.97∼0.99, P=0.004). Based on these four variables, a predictive nomogram was constructed. The nomogram demonstrated C-indexes of 0.664 and 0.728 for predicting 1-year and 2-year AF recurrence, respectively, in the validation cohort. The Kaplan-Meier survival analysis indicated that a Nomo-score greater than 128 was associated with a higher risk of AF recurrence.</p><p><strong>Conclusion: </strong>Hemodynamic parameters may offer valuable insight in predicting AF recurrence following catheter ablation. Our study successfully developed a reliable nomogram based on echocardiographic hemodynamic parameters to estimate the risk of AF recurrence after catheter ablation in NVAF patients.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development and validation of a predictive model for atrial fibrillation recurrence post-catheter ablation in non-valvular atrial fibrillation patients based on hemodynamic parameters.\",\"authors\":\"Decai Zeng, Shuai Chang, Xiaofeng Zhang, Yanfen Zhong, Yongzhi Cai, Tongtong Huang, Ji Wu\",\"doi\":\"10.1016/j.hrthm.2024.08.058\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The influence of hemodynamic parameters on the recurrence of atrial fibrillation (AF) following catheter ablation is not well known, and it remains unclear whether a nomogram combining risk factors and hemodynamic parameters improves prediction accuracy.</p><p><strong>Objective: </strong>This study aimed to develop a nomogram based on echocardiographic hemodynamic parameters for predicting AF recurrence following catheter ablation in non-valvular atrial fibrillation (NVAF).</p><p><strong>Methods: </strong>A total of 380 consecutive NVAF patients undergoing AF catheter ablation treatment were prospectively collected. Patients were divided into training and validation cohorts at a 7:3 ratio. The follow-up duration averaged 9 months with a median of 12 months, during which 132 patients (34.7%) experienced a recurrence of AF.</p><p><strong>Results: </strong>LASSO regression and Cox regression analyses identified four significant predictors of AF recurrence: persistent AF (HR=1.63, 95% CI=1.02∼2.61, P=0.041), the systolic/diastolic (S/D) ratio (HR=0.50, 95% CI=0.30∼0.84, P=0.009), left atrial acceleration factor α (HR=1.31, 95% CI=1.02∼1.68, P=0.032), and left atrial appendage peak emptying flow velocity (HR=0.98, 95% CI=0.97∼0.99, P=0.004). Based on these four variables, a predictive nomogram was constructed. The nomogram demonstrated C-indexes of 0.664 and 0.728 for predicting 1-year and 2-year AF recurrence, respectively, in the validation cohort. The Kaplan-Meier survival analysis indicated that a Nomo-score greater than 128 was associated with a higher risk of AF recurrence.</p><p><strong>Conclusion: </strong>Hemodynamic parameters may offer valuable insight in predicting AF recurrence following catheter ablation. Our study successfully developed a reliable nomogram based on echocardiographic hemodynamic parameters to estimate the risk of AF recurrence after catheter ablation in NVAF patients.</p>\",\"PeriodicalId\":12886,\"journal\":{\"name\":\"Heart rhythm\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2024-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart rhythm\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hrthm.2024.08.058\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.08.058","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Development and validation of a predictive model for atrial fibrillation recurrence post-catheter ablation in non-valvular atrial fibrillation patients based on hemodynamic parameters.
Background: The influence of hemodynamic parameters on the recurrence of atrial fibrillation (AF) following catheter ablation is not well known, and it remains unclear whether a nomogram combining risk factors and hemodynamic parameters improves prediction accuracy.
Objective: This study aimed to develop a nomogram based on echocardiographic hemodynamic parameters for predicting AF recurrence following catheter ablation in non-valvular atrial fibrillation (NVAF).
Methods: A total of 380 consecutive NVAF patients undergoing AF catheter ablation treatment were prospectively collected. Patients were divided into training and validation cohorts at a 7:3 ratio. The follow-up duration averaged 9 months with a median of 12 months, during which 132 patients (34.7%) experienced a recurrence of AF.
Results: LASSO regression and Cox regression analyses identified four significant predictors of AF recurrence: persistent AF (HR=1.63, 95% CI=1.02∼2.61, P=0.041), the systolic/diastolic (S/D) ratio (HR=0.50, 95% CI=0.30∼0.84, P=0.009), left atrial acceleration factor α (HR=1.31, 95% CI=1.02∼1.68, P=0.032), and left atrial appendage peak emptying flow velocity (HR=0.98, 95% CI=0.97∼0.99, P=0.004). Based on these four variables, a predictive nomogram was constructed. The nomogram demonstrated C-indexes of 0.664 and 0.728 for predicting 1-year and 2-year AF recurrence, respectively, in the validation cohort. The Kaplan-Meier survival analysis indicated that a Nomo-score greater than 128 was associated with a higher risk of AF recurrence.
Conclusion: Hemodynamic parameters may offer valuable insight in predicting AF recurrence following catheter ablation. Our study successfully developed a reliable nomogram based on echocardiographic hemodynamic parameters to estimate the risk of AF recurrence after catheter ablation in NVAF patients.
期刊介绍:
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.