左心房直径与左心房容积指数预测心房颤动复发的比较

摘要

目的 探讨左心房直径(LAD)与左心房容积指教(LAVI)对转律成功患者心房颤动复发的预测价值.方法 选择2007年7月至2009年10月于我院药物或电转律成功并给予胺碘酮预防复发的心房颤动患者124例,对比心房颤动复发组与未复发组的临床特征,并进行logistic回归分析,以比较LAD和LAVI对于心房颤动复发的预测价值.结果 117例患者完成研究,1年内32例复发,复发率为27.4%.心房颤动复发组LAD、LAVI均高于未复发组,LAD(39.5±6.5)mm vs (36.2±4.2)mm (P＜0.01),LAVI 40.2±8.5 vs 32.4±6.6(P＜0.01);两组年龄、左心室射血分数、是否服用其他抗心律失常药以及是否合并有器质性心脏病差异无统计学意交.Logistic多元回归显示,LAVI为心房颤动复发的独立危险因素(OR=3.170,95%可信区间=1.463～6.868,P＜0.01).结论 与LAD比较,LAVI是更为准确的预测心房颤动复发的临床指标.%Objective To compare the value of left atrial diameter(LAD) and left atrial volume index(LAVI) in predicting recurrence of atrial fibrillation. Methods Retrospective study was performed on the medical records of 124 atrial fibrillation patients who had undergone cardioversion from 2007 July to 2009 October and taken amiodarone to prevent recurrence. The multivariate associations of long term results with clinical variables were analyzed. Results A total of 117 patients were enrolled. At the end of one year follow-up, 32 patients (27.4 ％ ) had recurrence of atrial fibrillation. LAD and LAVI of the recurrence group were higher than those of non-recurrence group,LAD(39. 5±6.5)mm vs (36.2±4.2) mm( P ＜0.01) and LADI 40.2±8.5 vs 32.4±6.6) ( P ＜0.01). There were no significant difference between the recurrence group and non-recurrence group in age, left ventricular ejection fraction, the methodology of antiarrhythmic and heart disease. Logistic regression analysis revealed that the only predictor for the recurrence of atrial fibrillation was LAVI( OR=3.1 70,95 ％ CI=1. 463-6. 868, P ＜0.01 ). Conclusion Compared with LAD, LAVI is a better parameter for predicting recurrence of atrial fibrillation