【作者】 王喆；

【导师】 董建增；

【作者基本信息】 首都医科大学 ， 内科学（心血管病）， 2016， 硕士

【摘要】 目的:持续性心房颤动(房颤)患者常合并有心室弥漫性心肌纤维化。心室纤维化可引起心室僵硬度增加,与心功能不全密切相关,是心血管疾病不良预后的危险因素。本研究采用心脏核磁共振(CMR)新技术弛豫时间映射图(T1mapping)成像技术对入组人员左心室纤维化程度进行定量分析,探讨左心室纤维化程度对持续房颤患者射频消融预后的影响。方法:32名健康志愿者(10名女性,平均年龄47.7±12.2岁)及80名第一次接受射频消融手术治疗的持续性房颤患者(12名女性,平均年龄55.72±11.3岁)入组本研究并接受3.0T心脏核磁共振检查,测量左心室平均心肌T1值并计算细胞外容积分数(Extracellular volume fraction,ECV)。持续房颤患者均接受房颤导管射频消融(Radiofrequency Catheter Ablation,RFCA)治疗,术后定期随访心律失常复发情况。结果:截至2016年2月,平均随访(8.9±3.1)月。55位患者维持窦性心律,25位患者复发,无死亡。COX回归分析显示ECV大于28.71%(HR 8.185;95.0%CI 1.891-35.431)与左心房前后径(Left ventricle dimension,LAD)(HR 1.056;95.0%CI 1.003-1.096)是RFCA术后房颤复发的独立危险因素。结论:CMR测定左心室ECV增大是持续性房颤患者射频消融术后复发的独立预测因子。更多还原

【Abstract】 Objecctive: Cardiac magnetic resonance(CMR) imaging provides detailed tissue characterization, identifying diffuse fibrosis with T1 mapping. This study aimed to evaluate diffuse myocardial fibrosis in the left ventricle(LV) with CMR, and to investigate the relationship between extracellular volume fraction(ECV) with recurrence of atrial fibrillation(AF)after radiofrequency catheter ablation in the patients with persistent atrial fibrillation.Methods:Thirty-two healthy persons and eighty patients undergoing radiofrequency catheter ablation(RFCA)for atrial fibrillation were performed preprocedure CMR to determine ventricular T1 time and calculate ECV. All patients were followed up routinely.Results:At a mean follow-up of 8.9 ± 3.1months,AF was developed in 25 patients(31.25%). After multivariate analysis, ECV exceed 28.71%(HR 8.185;95.0% CI 1.891-35.431) and left atrium dimension(LAD)( HR 1.056; 95.0% CI 1.003-1.096)were the independent predictors of recurrence of AF.Conclusions:Increased ECV detected by CMR is associated with AF recurrence after RFCA in the patients with persistent AF.更多还原