40岁以上继发孔房间隔缺损患者介入封堵术前后心房颤动发生率与相关因素分析

朱涛; 许祥; 黄海韵; 万陈; 刘锋; 蒋新凤; 王文婷; 李华康; 姚青; 郭燕丽; 宋治远

doi:10.16016/j.2097-0927.202206151

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40岁以上继发孔房间隔缺损患者介入封堵术前后心房颤动发生率与相关因素分析

临床医学 | 更新时间：2026-01-09

- 40岁以上继发孔房间隔缺损患者介入封堵术前后心房颤动发生率与相关因素分析
- Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure
- 陆军军医大学学报 2022年44卷第21期页码：2211-2216
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：心血管内科
  2.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：超声科
- 作者简介：
  
  [宋治远，E-mail: zysong2010@126.com SONG Zhiyuan, E-mail: zysong2010@126.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202206151
  中图分类号： R181.32;R541.105;R541.75
- 收稿：2022-06-23，
  
  修回：2022-08-22，
  
  纸质出版：2022-11-15
- 稿件说明：
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朱涛, 许祥, 黄海韵, 等. 40岁以上继发孔房间隔缺损患者介入封堵术前后心房颤动发生率与相关因素分析[J]. 陆军军医大学学报, 2022,44(21):2211-2216.

Tao ZHU, Xiang XU, Haiyun HUANG, et al. Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure[J]. Journal of Army Medical University, 2022, 44(21): 2211-2216.
朱涛, 许祥, 黄海韵, 等. 40岁以上继发孔房间隔缺损患者介入封堵术前后心房颤动发生率与相关因素分析[J]. 陆军军医大学学报, 2022,44(21):2211-2216. DOI： 10.16016/j.2097-0927.202206151.

Tao ZHU, Xiang XU, Haiyun HUANG, et al. Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure[J]. Journal of Army Medical University, 2022, 44(21): 2211-2216. DOI： 10.16016/j.2097-0927.202206151.

摘要

目的

探讨房间隔缺损(atrial septal defect

ASD)患者介入封堵术前后心房颤动(atrial fibrillation

AF)的发生率，并分析其相关危险因素。

方法

选择2014年8月至2021年6月在本院住院并接受介入封堵术的40岁以上继发孔ASD患者为研究对象，通过医院病历资料库收集患者的相关资料，进行回顾性分析。根据介入封堵术前是否有AF分为ASD伴AF组和ASD窦性心律组；另根据术后随访期间有无新发AF分为新发AF组和窦性心律组。比较ASD伴AF组、ASD封堵术后新发AF组与对应窦性心律组间的相关资料。

结果

共纳入40岁以上ASD患者280例，其中男性75例、女性205例，年龄40~83(54.51±10.02)岁。ASD介入封堵术前AF发生率为16

.07%(45/280)，封堵术前呈窦性心律的235例；患者随访(42.40±23.98)个月，期间新发AF 15例(6.38%)。与ASD窦性心律组比较，ASD伴AF组患者年龄更大(

＜0.001)、NYHA心功能Ⅱ级以上比例更多(

=0.004)、左右心房内径明显增加(

＜0.001)，右心室压力明显增高(

＜0.001)；介入封堵术后新发AF组与窦性心律组比较，同样显示年龄(

＜0.001)、左心房内径(

=0.008)、右心房内径(

=0.003)及右心室内径(

=0.042)更大，左心室射血分数(LVEF)更低(

=0.004)。Logistic回归分析结果显示年龄、左心房内径增大、NYHA心功能分级≥Ⅱ级、右室压增高是ASD患者合并房颤危险因素，其中年龄是ASD患者介入封堵术后新发AF主要危险因素。

结论

40岁以上继发孔ASD患者介入封堵术前后AF发生率均较高，年龄大、心房内径增大及NYHA心功能分级较高、RVP增高可能是导致AF发生的危险因素，其中年龄是ASD患者介入封堵术后新发AF的主要危险因素。

Abstract

Objective

To assess the incidence of atrial fibrillation (AF) in patients with atrial septal defect (ASD)before and after interventional closure

and analyze the related risk factors.

Methods

A retrospective study was carried out in the ASD patients over 40 years old undergoing interventional closure in our hospital from August 2014 to June 2021. According the presence of AF or not before interventional closure

they were divided into ASD plus AF group and ASD plus sinus rhythm group. Based on the occurrence of new-onset AF or not after interventional closure

they were also assigned into new-onset AF group and sinus rhythm group. The related factors were analyzed by comparing those in the ASD plus AF group

new-onset AF group and the sinus rhythm groups.

Results

A total of 280 patients were recruited in this study

including 75 males and 205 females

at a mean age of 40~83(54.51±10.02) years. The incidence of AF in ASD patients before interventional closure was 16.07% (45/280). Of the 235 patients who were in sinus rhythm before interventional closure

15 (6.38%) patients developed new-onset AF during the follow-up of 42.40±23.98 months. In comparison to the patients who did not have AF

the patients who h

ad AF before interventional closure were significantly older (

0.001)

and with NYHA functional class Ⅱ or worse (

=0.004)

dilated both left and right atriums (

0.001) and higher right ventricular pressure (

0.001). Compared to the patients with sinus rhythm after interventional closure

those with new-onset AF were older (

0.001)

and with dilated left atrium (

=0.008)

right atrium (

=0.003) and right ventricle (

=0.042)

but a lower left ventricular ejection fraction (LVEF

=0.004). Logistic regression analysis showed that older age

dilated left atriums

NYHA functional class ≥Ⅱ and elevated right ventricular pressure were risk factors of AF

and age was the main risk factors of new-onset AF in ASD patients after interventional closure.

Conclusion

The incidence of AF is quite high in ASD patients over 40 years old no matter before or after interventional occlusion. Older age

dilated atriums

worse NYHA functional class and higher right ventricular pressure may be the risk factors for the occurrence of AF

and among them

age is the main risk factor of new-onset AF.

关键词

Keywords

references

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