心脏超声常规参数与HATCH评分对房颤射频消融术后复发的预测价值

王红雷; 贾静静; 杜来景; 董平栓; 邢适颖; 韩延辉; 杨旭明; 尚喜艳; 赵飞龙

doi:10.13201/j.issn.1001-1439.2016.03.006

心脏超声常规参数与HATCH评分对房颤射频消融术后复发的预测价值

- 河南科技大学第一附属医院心内科(河南洛阳, 471003)

详细信息

通讯作者: 董平栓,E-mail:dongpingshuan@163.com

中图分类号: R541.7

收稿日期: 2015-07-01

Predictive value of parameters of echocardiograph and HATCH score on atrial fibrillation recurrence post radiofrequency catheter ablation

- Department of Cardiology, The First Affiliated Hospital of He'nan Science and Technology University, Luoyang, He'nan, 471003, China

More Information

Corresponding author: DONG Pingshuan, E-mail: dongpingshuan@163.com

Received Date: 01 July 2015

摘要

摘要: 目的:分析心脏超声常规参数与阵发性心房颤动(房颤)进展风险评估指标(HATCH评分)的相关性,探讨两者与房颤射频消融术后复发的关系,为房颤消融术后易复发患者的治疗提供参考。方法:回顾并分析88例行房颤射频消融术的非瓣膜性阵发性房颤患者临床资料,复发定义为术后3个月出现持续时间超过30 s的快速性房性心律失常。将患者分为复发组和未复发组,分析HATCH评分与心脏超声相关指标的相关性,及其与房颤复发的关系。结果:仅左房(r=0.36,P=0.016)、肺动脉主干(r=0.33,P=0.009)、二尖瓣瓣口舒张早期血流速度(E峰)(r=0.47,P=0.001)与HATCH成正相关。多变量Logistic回归分析显示,仅左房(OR=1.31,95%CI:1.03~1.65,P=0.02)、HATCH(OR=3.29,95%CI:1.07~10.09,P=0.04)与房颤复发独立相关。左房40.5 mm是ROC曲线上的最佳临界点,预测房颤复发的灵敏度为66.7%,特异度为72.4%,曲线下面积为0.797;当HATCH为2.5时,灵敏度为26.7%,特异度为93.1%,曲线下面积为0.766。结论:HATCH评分与左房大小、肺动脉内径、E峰相关,可能会对房颤进展的预测提供额外的参考价值。HATCH评分与左房大小对预测房颤术后复发有重要的价值。
- 心房颤动 /
- HATCH评分 /
- 心脏超声 /
- 导管消融术 /
- 复发
Abstract: Objective:To analyze the correlation between the parameters of echocardiograph and paroxysmal atrial fibrillation progression risk assessment indicators(HATCH score), and to determine their predictive value on recurrence of atrial fibrillation(AF) after radiofrequeney catheter ablation(RFCA).Method:The data of 88 consecutive paroxysmal AF patientswho underwent RFCA were retrospectively analyzed. The recurrence was defined as atrial tachyarrhythmia lasting more than 30 seconds after 3 months post RFCA. The patients were divided into recurrence group and no recurrence group.The correlation of parameters of echocardiograph and HATCH score was analyzed by using Spearman rank. Relationship between HATCH score and parameters of echocardiograph and recurrence was observed.Result:Left atrial diameter (r=0.36,P=0.016), main pulmonary artery diameter(r=0.33,P=0.009) and early diastolic blood flow velocity of mitral valve orifice(E peak) (r=0.47,P=0.001) were positively related to the HATCH score. Logistic regression analysis revealed that left atrial diameter (OR=1.31, 95%CI:1.03-1.65,P=0.02) and HATCH(OR=3.29,95%CI:1.07-10.09,P=0.04) were correlated independently with the recurrence of AF.Left atrial diameter was 40.5 mm as the best critical point on the ROC curve, the sensitivity of the predicting risk of progression was 66.7%, the specificity was72.4%,the area under the curve was 0.797.HATCH was 2.5 as the best critical point on the ROC curve,the sensitivity of the predicting risk of progression was 26.7%, the specificity was 93.1%, the area under the curve was 0.766.Conclusion:Left atrial diameter, main pulmonary artery diameter and E peak may be noninvasive indicator of predicting progression of paroxysmal atrial fibrillation to persistent atrial fibrillation. Higher HATCH score and large left atrial diameter areassociated with the increased risk of AF recurrence post RFCA.
- atrial fibrillation /
- HATCH score /
- echocardiography /
- radiofrequeney catheter ablation /
- recurrence

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