Risk factors of incomplete endothelialization after left atrial appendage occlusion in patients with atrial fibrillation

IF 3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Archives of Medical Science Pub Date : 2024-06-07 DOI:10.5114/aoms/188529

Jia-min Chen, Z. Ruan, Gecai Chen, Jun-Guo Zhu, Yin Ren, Li Zhu

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引用次数: 0

Abstract

Introduction: We aimed to investigate the risk factors of incomplete device endothelialization (IDE) following left atrial appendage occlusion (LAAO) and provide a nomogram model for predicting the risks of IDE in patients with atrial fibrillation (AF).A total of 145 patients with AF who performed LAAO were included. The endothelialization of the occluder was assessed by computed tomography angiography (CTA) at 3 months after LAAO. Logistic regression analysis was used to explore the risk factors of IDE after LAAO. A nomogram model was constructed to predict the risks of IDE.53 cases with complete endothelialization (CDE group) and 92 cases with IDE (IDE group) were detected at 3 months after LAAO. There was significant difference in mitral regurgitation (MR) [37.7% vs 55.4%, p=0.040], left atrial appendage (LAA) diameter [(2.22±0.36) cm vs (2.61±2.11) cm, p=0.003], occluder size [(2.76±0.36) cm vs (2.93±0.34) cm, p=0.005] and the level of serum urea [(5.78±1.72) mmol/L vs (6.67±2.82) mmol/L, p=0.020] between the two groups. Serum urea level, MR, LAA diameter and large occluder size were independent risk factors for IDE (p=0.038, 0.041, 0.007 and 0.006, respectively). A nomogram prediction model based on MR, LAA diameter, occluder size and serum urea was constructed with a C-index of 0.70, while C-index of veriﬁcation 0.708.MR, higher serum urea level, LAA diameter and large occluder size may contribute to IDE after LAAO. The nomogram model based on MR, LAA diameter, occluder size and serum urea can be used to predict the IDE after LAAO.

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心房颤动患者左心房阑尾闭塞后内皮化不完全的风险因素

导言：我们旨在研究左心房阑尾封堵术（LAAO）后器械内皮化（IDE）不完全的风险因素，并提供一个预测心房颤动（AF）患者IDE风险的提名图模型。共纳入 145 名接受 LAAO 的房颤患者，在 LAAO 术后 3 个月通过计算机断层扫描血管造影术（CTA）评估封堵器的内皮化情况。采用逻辑回归分析探究 LAAO 后 IDE 的风险因素。LAAO 术后 3 个月，53 例完全内皮化（CDE 组）和 92 例 IDE（IDE 组）被检测到。二尖瓣反流（MR）[37.7% vs 55.4%，P=0.040]、左心房附壁（LAA）直径[（2.22±0.36）cm vs （2.61±2.11）cm，P=0.003]、封堵器大小[（2.76±0.36）cm vs（2.93±0.34）cm，P=0.005]和血清尿素水平[（5.78±1.72）mmol/L vs（6.67±2.82）mmol/L，P=0.020]在两组之间存在差异。血清尿素水平、MR、LAA 直径和大封堵器尺寸是 IDE 的独立危险因素（分别为 p=0.038、0.041、0.007 和 0.006）。基于 MR、LAA 直径、闭塞器大小和血清尿素的提名图预测模型的 C 指数为 0.70，而验证指数为 0.708。MR、较高的血清尿素水平、LAA 直径和闭塞器大可能是导致 LAAO 后 IDE 的原因。基于 MR、LAA 直径、闭塞器大小和血清尿素的提名图模型可用于预测 LAAO 后的 IDE。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Medical Science 医学-医学：内科

CiteScore

4.90

自引率

7.90%

发文量

139

审稿时长

1.7 months

期刊介绍： Archives of Medical Science (AMS) publishes high quality original articles and reviews of recognized scientists that deal with all scientific medicine. AMS opens the possibilities for young, capable scientists. The journal would like to give them a chance to have a publication following matter-of-fact, professional review by outstanding, famous medical scientists. Thanks to that they will have an opportunity to present their study results and/or receive useful advice about the mistakes they have made so far. The second equally important aim is a presentation of review manuscripts of recognized scientists about the educational capacity, in order that young scientists, often at the beginning of their scientific carrier, could constantly deepen their medical knowledge and be up-to-date with current guidelines and trends in world-wide medicine. The fact that our educational articles are written by world-famous scientists determines their innovation and the highest quality.