国际医学放射学杂志2025，Vol.48Issue(3)：293-299,7.DOI:10.19300/j.2025.L21761
基于心脏CT左心耳与左上肺静脉最短距离对射频消融术后房颤复发的预测价值
Predictive value of the minimum distance between the left atrial appendage and left superior pulmonary vein on cardiac CT for atrial fibrillation recurrence after radiofrequency ablation
吴丹丹 1王军 1原媛 2朱晓梅 1祝因苏 3陈红武 4徐怡1
作者信息
- 1. 南京医科大学第一附属医院放射科,南京 210029
- 2. 内蒙古科技大学包头医学院第二附属医院放射科
- 3. 南京医科大学附属肿瘤医院放射科
- 4. 南京医科大学第一附属医院心内科
- 折叠
摘要
Abstract
Objective To investigate the predictive value of the minimum distance between left atrial appendage(LAA)and left superior pulmonary vein(LSPV),measured on cardiac computed tomography(CT),for atrial fibrillation(AF)recurrence within 2 years after the first radiofrequency ablation procedure.Methods A retrospective analysis was conducted on the clinical and imaging data of 342 AF patients who underwent cardiac CT,with a median age of 64(56,71)years.Based on recurrence status within 2 years,patients were divided into a recurrence group(n=106)and a non-recurrence group(n=236).Differences in clinical and cardiac CT parameters between the two groups were analyzed using the chi-square test or Mann-Whitney U test.Cox regression analysis was used to identify independent predictors of AF recurrence and construct predictive models.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate model performance,and DeLong's test was used to compare AUC values.Kaplan-Meier analysis was used to assess event-free survival,and the log-rank test was used to compare survival between groups.Results The proportion of patients with an end-diastolic LAA-LSPV distance(LAA-LSPVend-diastolic)<2 mm was significantly higher in the recurrence group than in the non-recurrence group(P<0.05).The recurrence group also had significantly higher end-diastolic and end-systolic volume indices of the left atrium and LAA(LAVImax,LAVImin,LAAVImax,LAAVImin)compared to the non-recurrence group(all P<0.05).Multivariate Cox regression identified(LAA-LSPVend-diastolic)<2 mm,LAAVImax,persistent AF,and NT-proBNP as independent predictors of recurrence.Three predictive models were developed:Model 1:clinical parameters only(persistent AF+NT-proBNP);Model 2:Model 1+LAAVImax;Model 3:Model 2+LAA-LSPVend-diastolic<2 mm.Model 3 had significantly better predictive performance than both Model 1(Z=2.829,P<0.05)and Model 2(Z=2.246,P<0.05).Conclusion LAA-LSPVend-diastolic<2 mm is an independent predictor of AF recurrence within 2 years after ablation and provides incremental prognostic value.关键词
心脏/体层摄影术,X线计算机/心房颤动/左心耳/左上肺静脉/射频消融Key words
Cardiac/Tomography,X-ray computed/Atrial fibrillation/Left atrial appendage/Left superior pulmonary vein/Radiofrequency ablation分类
特种医学引用本文复制引用
吴丹丹,王军,原媛,朱晓梅,祝因苏,陈红武,徐怡..基于心脏CT左心耳与左上肺静脉最短距离对射频消融术后房颤复发的预测价值[J].国际医学放射学杂志,2025,48(3):293-299,7.
