[1]刘 倩,韩 丹,王飞扬,等.频发室性早搏与心脏瓣膜手术同期迷宫手术后心房颤动复发关系研究[J].陕西医学杂志,2024,(9):1215-1219.[doi:DOI:10.3969/j.issn.1000-7377.2024.09.013]
 LIU Qian,HAN Dan,WANG Feiyang,et al.Relationship between frequent ventricular premature beat and recurrence of atrial fibrillation after cardiac valve surgery with concurrent cox-maze ablation[J].,2024,(9):1215-1219.[doi:DOI:10.3969/j.issn.1000-7377.2024.09.013]
点击复制

频发室性早搏与心脏瓣膜手术同期迷宫手术后心房颤动复发关系研究
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年9期
页码:
1215-1219
栏目:
临床研究
出版日期:
2024-09-05

文章信息/Info

Title:
Relationship between frequent ventricular premature beat and recurrence of atrial fibrillation after cardiac valve surgery with concurrent cox-maze ablation
作者:
刘 倩1韩 丹2王飞扬1杨 超1师 桃1
(1.西安交通大学第一附属医院心血管外科,陕西 西安 710061; 2.西安交通大学第一附属医院医务部,陕西 西安 710061)
Author(s):
LIU QianHAN DanWANG FeiyangYANG ChaoSHI Tao
(Department of Cardiovascular Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
关键词:
心脏瓣膜病 糖尿病 室性早搏 心房颤动 风险分层 射频消融迷宫手术
Keywords:
Valvular heart disease Diabetes Ventricular premature beats Atrial fibrillation Risk stratification Cox-maze ablation
分类号:
R 542.5
DOI:
DOI:10.3969/j.issn.1000-7377.2024.09.013
文献标志码:
A
摘要:
目的:探讨频发室性早搏(VPB)与心脏瓣膜手术同期射频消融迷宫手术(CMA)后心房颤动(AF)复发的关系。方法:收集因瓣膜疾病合并AF行心脏瓣膜手术同期射频消融迷宫手术的患者115例进行单中心、回顾性、病例对照研究,按照AF是否复发进行分组,复发AF患者23例,未复发患者92例。收集患者一般临床资料和相关实验室检查并评估术前室性早搏负荷(室性早搏数量>10000个/24 h为频发室性早搏)。采用单因素和多因素Cox比例风险回归模型对合并瓣膜疾病的AF患者在接受心脏瓣膜手术及同期射频消融迷宫手术后AF复发的危险因素进行分析。结果:与未复发组比较,复发组室性早搏负荷较高(P<0.05)。多因素Cox回归分析结果显示,频发室性早搏和糖尿病是进行心脏瓣膜手术并同期接受射频消融迷宫手术的患者AF复发的独立危险因素(均P<0.05)。结论:频发室性早搏是心脏瓣膜手术同期射频消融迷宫手术后心房颤动复发的危险因素。
Abstract:
Objective:To investigate the relationship between ventricular premature beat(VPB)and recurrence of atrial fibrillation(AF)after cardiac valve surgery with concurrent cox-maze ablation(CMA).Methods:A single-center,retrospective,case-control study was conducted involving 115 patients who underwent valvular surgery with concurrent CMA for valvular disease with AF.The patients were grouped based on whether they experienced a recurrence of AF,with 23 patients in the recurrence group and 92 in the non-recurrence group.General clinical data and relevant laboratory date were collected,and the preoperative burden of VPB(defined as more than 10000 VPBs per 24 hours)was assessed.The risk factors for AF recurrence following the procedure by univariate and multivariate Cox regression analysis were analyzed.Results:The burden of VPB in the recurrence group was significantly higher than that in non-recurrence group(P<0.05).The multivariate Cox regression analysis indicated that frequent VPB and diabetes were risk factors for the recurrence of AF after valvular surgery with concurrent CMA.Conclusion:Frequent VPB was risk factor for the recurrence of AF following valvular surgery with concurrent CMA.

参考文献/References:

[1] JOGLAR J A,CHUNG M K,ARMBRUSTER A L,et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation:A report of the American college of cardiology/American heart association joint committee on clinical practice guidelines[J].Circulation,2023,149(1):e1-e156.
[2] 干佳琦,胡梦婷,刘梅.胺碘酮联合厄贝沙坦对高血压合并房颤患者心率变异性及血清N末端B型钠尿肽前体、基质金属蛋白酶-2、白细胞介素-6水平的影响[J].陕西医学杂志,2023,52(10):1388-1391.
[3] 俞婷,刘娜娜,钟青,等.沙库巴曲缬沙坦与传统血管紧张素转化酶抑制剂/血管紧张素受体拮抗剂治疗阵发性房颤疗效对比观察[J].陕西医学杂志,2023,52(10):1407-1410.
[4] 郭豫涛.中国老年心房颤动临床流行病学和抗栓管理现状及变化[J].中华老年心脑血管病杂志,2017,19(9):988-990.
[5] ANDRADE J,KHAIRY P,DOBREV D,et al.The clinical profile and pathophysiology of atrial fibrillation:Relationships among clinical features,epidemiology,and mechanisms[J].Circulation Research,2014,114(9):1453-1468.
[6] 胡华超,陈娴雅,谢思媛,等.心房颤动合并心力衰竭患者的临床特点及治疗现状分析的多中心研究[J].中国全科医学,2023,26(5):541-549.
[7] ANTER E,JESSUP M,CALLANS D J.Atrial fibrillation and heart failure:Treatment considerations for a dual epidemic[J].Circulation,2009,119(18):2516-2525.
[8] MATTHEW A C,MARAT F,ADAM D D,et al.Heart failure and atrial fibrillation,like fire and fury[J].JACC:Heart Failure,2019,7(6):447-456.
[9] 童惠平,李绒.心电图和超声心动图联合检查在非瓣膜性房颤患者左房室血栓诊断中的临床价值[J].陕西医学杂志,2021,50(7):811-813,817.
[10] 文小霞,魏高利,齐茗.后天性心脏瓣膜病患者手术前后心脏功能和心肌相关指标变化及与预后关系分析[J].陕西医学杂志,2020,49(4):427-430.
[11] GILLINOV M A,SIRAK J,BLACKSTONE H E,et al.The Cox maze procedure in mitral valve disease:Predictors of recurrent atrial fibrillation[J].The Journal of Thoracic and Cardiovascular Surgery,2005,130(6):1653-1660.
[12] 叶岗,罗文利,柳达,等.老年退行性瓣膜病并发心房纤颤患者心房结构特点分析[J].陕西医学杂志,2018,47(1):47-49.
[13] RUAENGSRI C,SCHILL M R,KHIABANI A J,et al.The Cox-maze Ⅳ procedure in its second decade:Still the gold standard[J].European Journal of Cardio-Thoracic Surgery,2018,53(S1):19-25.
[14] PENG Z,ZHAO R,LIU Y H,et al.Effect of preablation glycemic control on outcomes of atrial fibrillation patients with diabetes mellitus following valvular surgery combined with the cox-maze Ⅳ procedure[J].Frontiers in Cardiovascular Medicine,2022,9:898642.
[15] FORKMANN M,SCHWAB C,EDLER D,et al.Characteristics of early recurrences detected by continuous cardiac monitoring influencing the long-term outcome after atrial fibrillation ablation[J].Journal of Cardiovascular Electrophysiology,2019,30(10):1886-1893.
[16] 孙婷婷,魏哲,郑书敏,等.自主神经调控房颤的作用机制及中医药治疗研究进展[J].陕西中医,2019,40(1):135-137.
[17] 洪昌明.心房颤动发病机制研究历史的思考[J].医学与哲学(临床决策论坛版),2011,32(1):44-45.
[18] 李含,蔡薇.心房颤动的发病机制及治疗进展[J].实用心电学杂志,2024,33(1):87-92.
[19] CARNAGARIN R,KIUCHI M G,HO J K,et al.Sympathetic nervous system activation and its modulation:Role in atrial fibrillation[J].Frontiers in Neuroscience,2018,12:1058.
[20] XI Y T,CHENG J.Dysfunction of the autonomic nervous system in atrial fibrillation[J].Journal of Thoracic Disease,2015,7(2):193-198.
[21] QIN M,ZENG C,LIU X.The cardiac autonomic nervous system:A target for modulation of atrial fibrillation[J].Clinical Cardiology,2019,42(6):644-652.
[22] 孟宏,王桂青,杜竹君.西红花苷通过调控TLR4/MyD88/NF-kB通路改善糖尿病大鼠视网膜病变机制研究[J].陕西医学杂志,2023,52(5):531-535,540.
[23] 张永康,葛吉林.胰激肽原酶联合微脉冲治疗增殖性糖尿病视网膜病变疗效及对患者视网膜功能、炎症因子的影响[J].陕西医学杂志,2023,52(2):204-207.
[24] 梁蒙,杨雀,陈伟国,等.达格列净联合阿托伐他汀治疗糖尿病心肌病疗效及对患者Klotho和心室重构的影响[J].陕西医学杂志,2023,52(7):898-901.
[25] 刘广忠.心房颤动的危险因素分析及防治策略[J].中国现代医学杂志,2022,32(7):1-5.
[26] CHAO T F,KAZUYOSHI S,CHANG S L,et al.Atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation associated with diabetes mellitus or impaired fasting glucose[J].Am J Cardiol,2010,106(11):1615-1620.
[27] MARIJANA T,CESARE C.Type 2 diabetes mellitus and atrial fibrillation:From mechanisms to clinical practice[J].Archives of Cardiovascular Diseases,2015,108(4):269-276.
[28] OBERHAUSER V,SCHWERTFEGER E,RUTZ T,et al.Acetylcholine release in human heart atrium:Influence of muscarinic autoreceptors,diabetes,and age[J].Circulation,2001,103(12):1638-1643.

相似文献/References:

[1]武卫党,石 磊,张丹凤△,等.达格列净对糖尿病心肌缺血大鼠心肌功能改善作用的实验研究*[J].陕西医学杂志,2020,49(7):778.[doi:DOI:10.3969/j.issn.10007377.2020.07.003]
[2]杨 鲲,何 勇△,孙 静.比伐卢定与普通肝素对冠心病合并2型糖尿病患者经皮冠状动脉介入术凝血功能的影响研究*[J].陕西医学杂志,2020,49(9):1157.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.026]
 YANG Kun,HE Yong,SUN Jing..Effect of bivalirudin and unfractionated heparin on coagulation function in patients with coronary heart disease complicated with type 2 diabetes mellitus undergoing PCI[J].,2020,49(9):1157.[doi:DOI:10.3969/j.issn.1000-7377.2020.09.026]
[3]杨 旭,张致英,康龙丽,等.环状RNA与代谢性疾病研究进展[J].陕西医学杂志,2021,50(1):126.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.033]
 YANG Xu,ZHANG Zhiying,KANG Longli,et al.Advances in circular RNA and metabolic diseases[J].,2021,50(9):126.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.033]
[4]杨 璐,于敬妮,张 赟,等.空腹血糖水平与免疫性葡萄膜炎发病相关性调查研究[J].陕西医学杂志,2021,50(5):630.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.029]
[5]罗诒财,李 昊.糖尿病患者种植体周围炎治疗研究进展[J].陕西医学杂志,2021,50(10):1318.[doi:DOI:10.3969/j.issn.1000-7377.2021.10.036]
 LUO Yicai,LI Hao.Advances in the treatment of peri-implantitis in diabetic patients[J].,2021,50(9):1318.[doi:DOI:10.3969/j.issn.1000-7377.2021.10.036]
[6]李 琳,马红侠.血清25羟维生素D与肥胖/超重糖尿病患者合并甲状腺功能亢进相关性研究[J].陕西医学杂志,2022,51(1):70.[doi:DOI:10.3969/j.issn.1000-7377.2022.01.018]
[7]姜 飞,王东玉.依达拉奉右莰醇联合尿激酶静脉溶栓治疗急性脑梗死合并糖尿病对患者血清氧化应激水平、颈总动脉内-中膜厚度、血清基质金属蛋白酶-12水平的影响[J].陕西医学杂志,2022,51(1):88.[doi:DOI:10.3969/j.issn.1000-7377.2022.01.023]
 JIANG Fei,WANG Dongyu.Effects of edaravone dexborneol combined with urokinase intravenous thrombolysis on serum oxidative stress,common carotid artery intra-media thickness and serum MMP-12 in patients with acute cerebral infarction and diabetes mellitus[J].,2022,51(9):88.[doi:DOI:10.3969/j.issn.1000-7377.2022.01.023]
[8]马昱杭,韩昀屹,韩者艺.顶端钠依赖性胆酸转运体及其在相关疾病中的作用研究进展[J].陕西医学杂志,2022,51(9):1163.[doi:DOI:10.3969/j.issn.1000-7377.2022.09.028]
 MA Yuhang,HAN Yunyi,HAN Zheyi.Advances in apical sodium-dependent bile acid transporter and its role in related diseases[J].,2022,51(9):1163.[doi:DOI:10.3969/j.issn.1000-7377.2022.09.028]
[9]吕艳红,刘朵朵,李 佳.新型冠状病毒奥密克戎变异株感染轻型及无症状患者核酸转阴时间影响因素分析[J].陕西医学杂志,2022,51(12):1511.[doi:DOI:10.3969/j.issn.1000-7377.2022.12.010]
[10]水 淼,杨国科,江 江.康柏西普玻璃体腔注射联合普拉洛芬局部给药治疗糖尿病性白内障术后黄斑水肿疗效观察[J].陕西医学杂志,2024,(12):1676.[doi:DOI:10.3969/j.issn.1000-7377.2024.12.018]
 SHUI Miao,YANG Guoke,JIANG Jiang.Efficacy of intravitreal injection of conbercept combined with local administration of pranoprofen on macular edema after diabetic cataract surgery[J].,2024,(9):1676.[doi:DOI:10.3969/j.issn.1000-7377.2024.12.018]

备注/Memo

备注/Memo:
基金项目:陕西省自然科学基金资助基础研究计划项目(2021JQ-394)
更新日期/Last Update: 2024-09-04