[1]张佳圩 黄从新.预防心房纤维化对心房颤动患者射频消融术后复发的影响[J].心血管病学进展,2020,(1):89-93.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.024]
 ZhANG Jiawei,HUANG Congxin.Prevention of Atrial Fibrosis Affects Atrial Fibrillation Recurrence after Radiofrequency Ablation[J].Advances in Cardiovascular Diseases,2020,(1):89-93.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.024]
点击复制

预防心房纤维化对心房颤动患者射频消融术后复发的影响()
分享到:

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年1期
页码:
89-93
栏目:
论著
出版日期:
2020-02-04

文章信息/Info

Title:
Prevention of Atrial Fibrosis Affects Atrial Fibrillation Recurrence after Radiofrequency Ablation
作者:
张佳圩 黄从新 
(武汉大学人民医院心内科 武汉大学心血管病研究所 心血管病湖北省重点实验室,湖北 武汉 430060)
Author(s):
ZhANG JiaweiHUANG Congxin
(Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University ; Hubei Key Laboratory of Cardiology ; Wuhan 430060 , H ubei, China) (2016ACA153) E-mail: huangcongxin@vip.163.com
关键词:
心房颤动射频消融术复发心房纤维化
Keywords:
Atrial fibrillation Radiofrequency ablation Recurrence Atrial fibrosis
DOI:
10.16806/j.cnki.issn.1004-3934.2020.01.024
摘要:
目的 探讨心房纤维化的药物预防对心房颤动(房颤)患者射频消融术后复发的影响。 方法 选取2017年6月—2018年3月于武汉大学人民医院行首次射频消融术的非瓣膜性房颤患者112例。收集患者临床资料并进行随访,记录患者术后预防心房纤维化的药物类型和剂量,根据随访1年的结果将患者分为术后复发组(n=19)和未复发组(n=83)。比较两组患者一般资料、实验室检查和服用药物的差异,采用SPSS 22数据分析判断心房纤维化的药物预防对房颤患者射频消融术后复发的影响。结果 房颤患者消融术后复发组与未复发组的性别、年龄、房颤类型、高血压、糖尿病、冠心病等疾病、 hs-CRP、eGFR、SCr、UA的差异无统计学意义(P>0.05),复发组的房颤初发年龄、房颤病史及NT-pro BNP水平明显高于未复发组(P<0.05)。药物预防心房纤维化可减少房颤患者射频消融术后的1年复发率(P=0.015),较长的房颤病史是房颤术后复发的独立危险因素。结论 房颤患者射频消融术后复发率与房颤初发年龄、房颤病史、NT-proBNP水平相关,药物预防心房纤维化可降低房颤患者射频消融术后的1年复发率。
Abstract:
Objective To investigate the effect of preventing atrial fibrosis on atrial fibrilation recurrence after radiofrequency ablation (RFCA) in patients with nonvalvular atrial fibrillation(NVAF).Methods A total of 112 patients with NVAF after first RFCA at Renmin Hospital of Wuhan University from June 2017 to March 2018 were enrolled and followed up for 1 year. After one-year follow-up,the patients can be divided into recurrent group( n=19) and non-recurrent group( n=83). Baseline information,laboratory examination results and medication-taking information were compared between the two groups, and the effect of anti-fibrosis medication on recurrence of atrial fibrillation(AF) were analyzed. Results Initial age of AF, history of AF, and NT-proBNP level in recurrent group were significantly higher than non-recurrent group( P<0.05).Meanwhile age, sex, AF type, hypertension, diabetes mellitus, hs-CRP, eGFR, SCr and UA showed no significant difference. Longer history of AF was an independent risk factor for recurrence of AF, and drugs to prevent atrial fibrosis could reduce the recurrence rate. Conclusion The recurrence rate of AF after RFCA is correlated with initial age of AF, history of AF and NT-proBNP level. Drugs to prevent atrial fibrosis can reduce the recurrence rate of AF after RFCA.

参考文献/References:

[1]Liu Y ,Niu XH,Yin XM,et al. Elevated circulating fibrocytes is a marker of left atrial fibrosis and recurrence of persistent atrial fibrillation[J]. J Am Heart Assoc,2018,7(6):e008083

[2] 黄从新,张澍,黄德嘉,等. 心房颤动:目前的认识和治疗的建议-2018[J]. 中国心脏起搏与心电生理杂志,2018,32(4):315-368.

[3] Dzeshka MS,Lip GY,Snezhitskiy V,et al. Cardiac fibrosis in patients with atrial fibrillation: mechanisms and clinical implications[J]. J Am Coll Cardiol,2015,66(8):943-959.

[4] Tzeis S,Asvestas D,Vardas P,et al. Atrial fibrosis:translational considerations for the management of AF patients[J]. Arrhythm Electrophysiol Rev,2019,8(1):37-41.

[5]King JB ,Azadani PN,Suksaranjit P,et al. Left atrial fibrosis and risk of cerebrovascular and cardiovascular events in patients with atrial fibrillation[J]. J Am Coll Cardiol,2017,70(11):1311-1321.

[6]Galenko O ,Jacobs V,Knight S,et al. The role of microRNAs in the development,regulation,and treatment of atrial fibrillation[J].J Interv Card Electrophysiol,2019,55(3):297-305.

[7] Moteleb AMAE,Zarif JK,Ali AN,et al. Incidence of atrial fibrosis in non-valvular atrial fibrillation patients and its impact on recurrence after pulmonary vein antral isolation[J]. J Atr Fibrillation,2018,11(1):1773.

[8]Nair GM ,Nery PB,Redpath CJ,et al. The role of renin angiotensin system in atrial fibrillation[J]. J Atr Fibrillation,2014,6(6):972.

[9]Thanigaimani S,Lau DH, Agbaedeng T,et al. Molecular mechanisms of atrial fibrosis:implications for the clinic[J]. Expert Rev Cardiovasc Ther,2017,15(4):247-256.

[10]Groves D,Mihos CG,Larrauri-Reyes M,et al. The use of statins in the treatment and prevention of atrial fibrillation[J]. Cardiol Rev,2016,24(5):224-229.

[11]Kawamura M,Ito H,Onuki T,et al. Candesartan decreases typeⅢprocollagen-N-peptide levels and inflammatory marker levels and maintains sinus rhythm in patients with atrial fibrillation[J]. J Cardiovasc Pharm acol,2010,55(5):511-517.

[12]Yang D,Yuan J,Liu G,et al. Angiotensin receptor blockers and statins could alleviate atrial fibrosis via regulating platelet-derived growth factor/Rac1/nuclear factor-kappa B axis[J]. Int J Med Sci,2013,10(7):812-824.

[13]Mayyas F,Alzoubi KH,van Wagoner DR,et al. Impact of aldosterone antagonists on the substrate for atrial fibrillation:aldosterone promotes oxidative stress and atrial structural/electrical remodeling[J]. Int J Cardiol,2013,168(6):5135-5142.

[14]刘刚,张恒. 他汀类药物对于心房颤动防治的研究进展[J].心血管病学进展, 2018,36(6):1068-1071.

[15]Francesco D,Monica G,Alessandro S,et al. Use of statins and recurrence of atrial fibrillation after catheter ablation or electrical cardioversion[J]. Thromb Haemost,2011,106(2):363-370.

[16]Kirchhof P ,Benussi S ,Kotecha D ,et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS [J]. Eur J Cardiothorac Surg,2016,50(5):1-88.

相似文献/References:

[1]贺鹏康,周菁.心房颤动治疗新技术——冷冻球囊消融[J].心血管病学进展,2016,(1):1.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.001]
 HE Pengkang,ZHOU Jing.Cryoballoon Ablation, A Novel Technology for Atrial Fibrillation Treatment[J].Advances in Cardiovascular Diseases,2016,(1):1.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.001]
[2]都明辉,施海峰*,佟佳宾,等.心房颤动消融相关性无症状性脑缺血[J].心血管病学进展,2016,(1):3.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.002]
 DU Minghui,SHI Haifeng*,TONG Jiabin,et al.Silent Cerebral Ischemia Related to Atrial Fibrillation Ablation[J].Advances in Cardiovascular Diseases,2016,(1):3.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.002]
[3]郑环杰,综述,肖骅,等.心房颤动抗栓治疗研究进展[J].心血管病学进展,2016,(2):142.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.012]
 ZHENG Huanjie,XIAO Hua.Progress of Antithrombotic Therapy in Patients with Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2016,(1):142.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.012]
[4]张清,综述,罗素新,等.新型Xa 因子抑制剂———依度沙班在心房颤动患者抗凝治疗中的研究进展[J].心血管病学进展,2016,(2):151.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.014]
 ZHANG Qing,LUO Suxin,TANG Jiong.Novel Factor Xa Inhibitors—Edoxaban in Prevention of Stroke in Patients with Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2016,(1):151.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.014]
[5]胡红玲,综述,罗素新,等.预防非瓣膜性心房颤动性脑卒中的治疗新进展[J].心血管病学进展,2016,(3):250.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.009]
 HU Hongling,LUO Suxin.New Progress in the Treatment for Cerebral Apoplexy of Nonvalvular Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2016,(1):250.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.009]
[6]王超,杨国澍,综述,等.关附甲素治疗心房颤动的研究进展[J].心血管病学进展,2016,(3):254.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.010]
 WANG Chao,YANG Guoshu,CAI Lin,et al.Research Progress of the Treatment of Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2016,(1):254.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.010]
[7]徐小东,综述,杨东辉,等.决奈达隆治疗心房颤动的现状及展望[J].心血管病学进展,2016,(4):368.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.011]
 XU Xiaodong,YANG Donghui.Status and Prospect of Dronedarone in Treating Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2016,(1):368.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.011]
[8]张莎,储国俊,吴弘.经导管左心耳封堵术的临床应用进展[J].心血管病学进展,2015,(5):547.[doi:10.3969/j.issn.1004-3934.2015.05.006]
 ZHANG Sha,CHU Guojun,WU Hong.Clinial Application Advances in Left Atrial Appendage Closure[J].Advances in Cardiovascular Diseases,2015,(1):547.[doi:10.3969/j.issn.1004-3934.2015.05.006]
[9]汪俊,杨浩.心房颤动射频消融的术式演变[J].心血管病学进展,2015,(5):574.[doi:10.3969/j.issn.1004-3934.2015.05.013]
 WANG Jun,YANG Hao.Evolution of Radiofrequency Ablation of Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2015,(1):574.[doi:10.3969/j.issn.1004-3934.2015.05.013]
[10]赵璐,苏立.心房颤动与离子通道重构研究进展[J].心血管病学进展,2015,(5):580.[doi:10.3969/j.issn.1004-3934.2015.05.014]
 ZHAO Lu,SU Li.Research Progress of Atrial Fibrillation and Ion Channel Remodeling[J].Advances in Cardiovascular Diseases,2015,(1):580.[doi:10.3969/j.issn.1004-3934.2015.05.014]
[11]罗亮 汤宝鹏 周贤惠.三尖瓣反流与心房颤动的研究进展[J].心血管病学进展,2024,(8):681.[doi:10.16806/j.cnki.issn.1004-3934.202.08.003]
 LUO Liang,TANG Baopeng,ZHOU Xianhui.Tricuspid Regurgitation and Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2024,(1):681.[doi:10.16806/j.cnki.issn.1004-3934.202.08.003]

备注/Memo

备注/Memo:
基金项目:湖北省技术创新专项(2016ACA153)
更新日期/Last Update: 2020-03-24