风湿性心脏病心房颤动患者心房纤维化程度与心房颤动复发的相关性

目的探讨风湿性心脏病心房颤动患者心房纤维化程度与心房颤动复发的相关性。方法68例风湿性心脏病二尖瓣病变患者(心房颤动50例,窦性心律18例)行心脏外科手术时取右心耳组织。应用V-G染色法和VIDAS-21图像分析系统测量心房组织胶原容积分数(CVF)。结果心房颤动患者的心房组织CVF(15.89%±1.29%)明显高于窦性心律患者(8.46%±3.45%,P<0.01)。术后50例心房颤动患者46例转复为窦性心律,4例转复未成功;随访12月后,维持窦性心律者35例(76.07%),心房颤动复发11例(23.97%);心房颤动复发患者心房组织CVF、心房颤动持续时间和左心房内径明显大于维持窦性心律组(P<0.05,P<0.01)。结论心房纤维化程度是引起风湿性心脏病心房颤动患者复律后心房颤动复发的因素之一。

Relationship between atrial fibrosis and atrial fibrillation recurrence in patients with rheumatic heart disease complicating atrial fibrillation

Objective To study the relationship between atrial fibrosis and atrial fibrillation recurrence in patients with rheumatic heart disease（RHD） complicating atrial fibrillation. Methods Tissue of right atrial appendage was obtained during open heart surgery in 68 patients with RHD（50 patients with atrial fibrillation patiens and 18 patients with sinus rhythm） ,collagen volume fraction（CVF） of atrial tissue were analyzed by V-G staining method and image analytical system. Results CVF of atrial tissue in patients with atrial fibrillation （ 15.89% ± 1.29 % ） were significantly higher than that in patients with sinus rhythms（8.46% ±3.45% ,P 〈0.01 ）. Among 50 cases of atrial fibrillation,46 cases recovered to sinus rhythms,4 cases were atrial fibrillation still. After 12 months follow-up, 35 cases （ 76.07 % ） maintained sinus rhythms, but 11 cases （ 23.97 % ） recured to atrial fibrillation. The CVF of atrial tissue, duration of atrial fibrillation and daimeter of left atrium in palients who converted to atrial fibrillation were significantly higher than these in patients who maintained sinus rhythm （P 〈 0.05, P 〈 0.01 ）. Conclusion The level of atrial fibration may be a factor of recidivation after cardioversion in patients with rheumatic heart disease complicating atrial fibrillation.