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对于心房动进行导管切除后,左心房和附属体的重塑和反向重塑

Tetsuma Kawaji¹, Takanori Aizawa², Issei Seto³

¹Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

The American journal of cardiology

|June 8, 2025

概括

在心房移除后的左心房和附属体重塑在非心房发作性AF中更为常见. 反向重塑在非PAF患者中显著,没有复发,而在PAF患者中,LA清空分数在废除后减少.

科学领域:

心脏病学心脏病学
医疗成像医学成像

背景情况:

左心房 (LA) 和左心房附属体 (LAA) 的改造在心房动 (AF) 病理生理学中至关重要.
导管切除对LA和LAA重塑的影响需要进一步研究.

研究的目的:

评估AF的导管切除后的LA和LAA重塑和反向重塑过程.
确定影响这些变化的因素及其与复发的关联.

主要方法:

分析了经过导管切除的372名AF患者,在手术前和后进行CT扫描.
测量了左心室体积 (LAV),LA排空分数 (LAEF),LAA体积 (LAAV) 和LAA排空分数 (LAAEF).
评估了与AF类型,复发和废除策略的关联.

主要成果:

非发热性AF (非PAF) 患者表现出更普遍的LA/LAA重塑,并与心力衰竭参数相关.
在剥离后观察到LA/LAA的反向重塑,LAEF和LAAEF显著增加.
动脉动脉的体积成为复发性动脉节律失常的独立风险因素 (aHR1.01,p=0.02).
反向重塑在非PAF患者中突出,没有复发.
在帕洛西斯马性AF (PAF) 患者中,LA排空分数下降,特别是在肺静脉隔离 (PVI) 以后进行额外的切除后.

结论:

在非PAF患者中,LA和LAA重塑更为普遍.
显著的LA和LAA逆转型发生在切除后,特别是在没有复发的非PAF患者中.
在废除后的PAF患者中,LA排空分数的减少需要进一步研究,特别是关于废除策略.

关键词:

心房动是心房动的一种.导管切除导管切除导管切除导管切除左心房空虚分数的部分左心房的体积是左心房的体积.反向改造是指逆向的改造.

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