左心瓣膜术后心房颤动与三尖瓣反流的关系

目的:研究左心瓣膜术后三尖瓣反流与术后心房颤动(房颤)的关系。方法:随访2002年3月至2008年11月接受主动脉瓣置换术或二尖瓣置换术,且未行三尖瓣成形术或三尖瓣置换术的患者374例,其中男性151例,女性223例,年龄23～79岁,平均(52±11)岁。所有患者均经过术前和术后彩色多普勒超声心动检查及心电图检查。单因素分析组间使用χ2检验。危险因素采用Logistic回归模型分析。结果:左心瓣膜术后房颤是术后发生三尖瓣反流的独立危险因素。Logistic多因素分析结果为:术后房颤、女性及术后左心房扩大,是术后三尖瓣反流的独立危险因素;术时年龄、术后左心室大小、术后右心室大小及术后射血分数这4项不是三尖瓣反流的危险因素。结论:左心瓣膜术后房颤是术后发生三尖瓣反流的独立危险因素。对于术后房颤应该引起重视,积极治疗。

The relationship between tricuspid regurgitation and atrial fibrillation after left-sided valve surgery

Objective:To investigate if atrial fibrillation(AF) is an independent risk factor for tricuspid regurgitation(TR) after left-sided heart valve surgery.Methods:374 cases were followed-up from March 2002 to November 2008 with aortic valve replacement or mitral valve replacement without tricuspid repaire or tricuspid valve replacement 151 male,223 female,23-79years old,mean age of(52±11) years.All patients underwent preoperative and postoperative color Doppler echocardiography and electrocardiogram(ECG).Univariate analysis between groups using the χ2 test.Using logistic regression model for risk factors analysis.Results: Postoperative AF is an independent risk factor for TR.Logistic multivariate analysis results reveal that: Postoperative AF,female gender,left atrial enlargement were independent risk factors for TR;age,size of left ventricular and right ventricular,ejection fraction of left ventricular after surgery were not risk factors for TR.Conclusion: AF after Left-sided heart valve surgery is an independent risk factor for TR.So it is important to notice that,postoperative AF should be treated actively.