[冠状动脉旁路移植术后慢性冠状动脉疾病患者新发心房颤动的预测因素：一项前瞻性、观察性、单中心、非随机研究]。

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2024-10-31 DOI:10.18087/cardio.2024.10.n2511

N Yu Sokolova, E A Savelyeva, K A Martynova, A D Makhauri, S R Medzhidov

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引用次数: 0

摘要

目的：研究冠状动脉旁路移植术（CABG）后慢性缺血性心脏病（IHD）患者术后心房颤动（POAF）发生的影响因素：这项单中心前瞻性非随机观察研究纳入了152名慢性缺血性心脏病患者。患者平均年龄为（64.4±5.9）岁。根据术后早期心房颤动（AF）的发生情况，将所有接受过 CABG 手术的患者分为两组：第一组，有 POAF（43 人；28.3%）；第二组，无 POAF（109 人；71.7%）。主要研究终点是 CABG 术后早期（住院）新发 POAF。次要研究终点是院内术后并发症（非致命/致命急性冠状动脉综合征（ACS）、非致命/致命中风、大出血、死亡）：与保留窦性心律的患者相比，POAF患者在CABG术后的心脏结构和功能变化更为明显：左心室（LV）容积增大，左心室心肌质量增加，左心室收缩功能参数降低，舒张功能受损，左心房（LA）腔增大。对院内并发症的分析表明，各组在发生 POAF 方面没有任何差异。POAF的危险因素如下：年龄大于65岁（p=0.022）、体重指数≥30.5 kg/m2（p=0.020）、心外膜脂肪组织厚度>10.5 mm（p=0.015）、LA容积指数>33 ml/m2（p<0.001）、左心室心肌质量指数>115 g/m2（p=0.042）、左主冠状动脉疾病>50%（p=0.043）、CABG术中心肺旁路时间>60 min（p=0.019）、CABG术后早期（第一天）血钾浓度<3.6 mmol/l（p<0.001）、术后早期心包积液量>88 ml（p<0.001）：结论：确定发生 POAF 的风险非常重要，对于术后密切监测慢性心肌缺血患者非常必要。

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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[Predictors of New-Onset Atrial Fibrillation in Patients With Chronic Coronary Artery Disease After Coronary Artery Bypass Grafting: a Prospective, Observational, Single-Centre, Non-Randomized Study].

Aim: To study the factors that influence the occurrence of postoperative atrial fibrillation (POAF) in patients with chronic ischemic heart disease (IHD) after coronary artery bypass grafting (CABG).

Material and methods: This single-center prospective observational non-randomized study included 152 patients with chronic IHD. Mean age of patients was 64.4±5.9 years. All patients after CABG were divided into two groups based on the occurrence of atrial fibrillation (AF) in the early postoperative period: group 1, with POAF (n=43; 28.3%) and group 2, without POAF (n=109; 71.7%). The primary study endpoint was new-onset POAF in the early postoperative (hospital) period after CABG. The secondary study endpoint was in-hospital postoperative complications (non-fatal/fatal acute coronary syndrome (ACS), non-fatal/fatal stroke, major bleeding, death).

Results: Patients with POAF had significantly more pronounced structural and functional changes in the heart than patients with preserved sinus rhythm after CABG: larger left ventricular (LV) volume, greater LV myocardial mass, lower LV systolic function parameters and impaired diastolic function, and an enlarged left atrial (LA) cavity. Analysis of in-hospital complications did not show any differences between the groups associated with the development of POAF. The following risk factors for POAF were identified: age older than 65 years (p=0.022), body mass index ≥30.5 kg/m2 (p=0.020), epicardial adipose tissue thickness >10.5 mm (p=0.015), indexed LA volume >33 ml/m2 (p<0.001), LV myocardial mass index >115 g/m2 (p=0.042), left main coronary artery disease >50% (p=0.043), duration of cardiopulmonary bypass during CABG >60 min (p=0.019), blood potassium concentration in the early postoperative period after CABG (on the first day) <3.6 mmol/l (p<0.001), and pericardial effusion volume in the early postoperative period >88 ml (p<0.001).

Conclusion: Determining the risk of developing POAF is important and necessary for the closest monitoring of a patient with chronic IHD in the postoperative period.

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.