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应用超声心动图预测冠状动脉搭桥术后房颤的多因素分析

金岩 王辉山 于岩 张南滨 姜辉 陶登顺

解放军医学杂志2012,Vol.37Issue(2):126-129,4.
解放军医学杂志2012,Vol.37Issue(2):126-129,4.

应用超声心动图预测冠状动脉搭桥术后房颤的多因素分析

Multivariate analysis of predictive effect of echocardiogram on atrial fibrillation after coronary artery bypass grafting

金岩 1王辉山 1于岩 1张南滨 1姜辉 1陶登顺1

作者信息

  • 1. 110810沈阳 沈阳军区总医院心外科
  • 折叠

摘要

Abstract

Objective To probe into the predictive effect of echocardiogram on atrial fibrillation after off-pump coronary artery bypass grafting. Methods The case-control research method was adopted to analyze 113 patients undergoing off-pump coronary artery bypass grafting (OPCAB). These patients were divided into AF and control groups based on the occurrence of atrial fibrillation. Multiple regression analysis was conducted on collected clinical data and echocardiographic data. Results Postoperative Atrial Fibrillation (POAF) occurred in 31 out of 113 patients (27.4%). Uni-factor analysis showed that age, wall motion integral (WMI), ratio of early (E) and late (A) transmitral inflow peak velocity (E/A), systolic peak velocity at lateral mitral annulus (S1), ratio of E and early diastolic peak velocities of lateral mitral annulus (E/E'), pulmonary artery systolic pressure (PASP), and mitral insufficiency (Ml) were significantly different between the AF and control groups (JP<0.05). However, multiple regression analysis showed that independent risk factors of POAF patients were ranged as MI, E/E', age, and PASP according to relative risk. 13 patients (72.2%) in the AF group still suffered from MI after the operation, but only six patients (23.1%) in control group had MI by analyzing the postoperative mitral valve regurgitation of 44 patients with preoperative MI (AF group 18 cases and control group 26 cases). A significant difference exists between two groups (P=0.00l), whereas the MI of the other 25 patients decreased or disappeared. In addition, the E/E' in both groups were 13.5 ± 4.9 and 9.9 ± 3.2, respectively, which showed a significant difference (P=0.005). Conclusion Independent risk factors in POAF of CABG were MI, E/E', age and PASP. Mitral valvuloplasty and CABG should be completed simultaneously in the MI patients with left ventricular diastolic dysfunction (E/E' ≥ 8-10).

关键词

心房颤动/冠状动脉旁路移植术,非体外循环/超声心动描记术,多普勒,彩色

Key words

atrial fibrillation/ coronary artery bypass, off-pump/ echocardiography, Doppler, color

分类

医药卫生

引用本文复制引用

金岩,王辉山,于岩,张南滨,姜辉,陶登顺..应用超声心动图预测冠状动脉搭桥术后房颤的多因素分析[J].解放军医学杂志,2012,37(2):126-129,4.

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