Left ventricular diastolic dysfunction combined with left atrial volume index predicts the risk of persistent atrial fibrillation after revascularization in patients with acute ST-segment elevation myocardial infarction
REN Feng, KOU Jin, MA Lanxiang, YANG Kun
Cardiovascular Department, Shaanxi Provincial Crops Hospital of Chinese People’s Armed Police Force,Xi’an 710000,China
Abstract：ObjectiveTo predict the occurrence of persistent atrial fibrillation after revascularization in patients with acute ST-segment elevation myocardial infarction (STEMI) by detecting the left atrial volume index (LAVI) and left ventricular function with echocardiographic Doppler.Methods A total of 256 patients who underwent emergency primary coronary intervention (PCI) in our hospital due to STEMI between January 2013 and December 2017 were enrolled in this study. Doppler echocardiography was used to detect the left atrial volume and LAVI. The follow-up lasted 2 years. The primary endpoint was defined as persistent atrial fibrillation with a duration of more than 7 days that was newly diagnosed within 2 years. The receiver operating curve (ROC) was used to determine the optimal cutoff for the left atrial diameter. Logistics regression analysis was used to identify independent predictors of endpoint events.Results Patients with an LAVI greater than 31 ml/m2 had a significantly higher risk of primary endpoint events within 2 years, with a predictive sensitivity of 0.89, a specificity of 0.60, and an approximated index of 0.49. Patients with left ventricular diastolic dysfunction (LVDD) had a significantly increased risk of primary endpoint events within 2 years, with a predictive sensitivity of 0.76, a specificity of 0.74, and an approximated index of 0.50, compared with 0.85, 0.89 and 0.74 for the combination of the LVDD and left atrial volume index. The multiple regression model of Logistics found that the recurrence of acute coronary events, left anterior descending artery lesions, LVDD and left ventricular volume index increase were independent risk factors for primary endpoint event within 2 years.Conclusions Left atrial enlargement and LVDD are independent predictors of persistent atrial fibrillation after revascularization in STEMI patients. The left atrial volume index combined with left ventricular diastolic function after PCI can help predict the risk of persistent atrial fibrillation in patients.
任锋, 寇进, 马兰香, 杨鲲. 左心室舒张功能不全联合左房容积指数预测急性ST段抬高型心肌梗死患者血运重建后持续性房颤的发生风险[J]. 武警医学, 2020, 31(3): 219-223.
REN Feng, KOU Jin, MA Lanxiang, YANG Kun. Left ventricular diastolic dysfunction combined with left atrial volume index predicts the risk of persistent atrial fibrillation after revascularization in patients with acute ST-segment elevation myocardial infarction. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(3): 219-223.
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2020, Vol. 31 
