CAJ | 학술논문

目的探讨饮酒程度对男性心房颤动(房颤)患者导管消融后房颤复发的影响.方法共连续入选初次进行射频消融治疗的男性房颤患者192例(持续性房颤64例,阵发性房颤128例),平均年龄(53.4± 10.3)岁.排除患有瓣膜性心脏病、近3个月内发生心肌梗死、左心室射血分数(LVEF) ＜0.50、甲状腺功能亢进,以及严重肝肾功能异常者.根据术前饮酒程度分为不饮酒、少中量饮酒和大量饮酒3组,并对比3组间临床特征及消融疗效的差异.进行单因素及Cox多元回归分析,评价房颤消融术后复发的预测因素.结果平均随访(17.7±6.1)个月,共66例(34.4％)患者复发房颤.其中,大量饮酒者(29.7％)的左心房内径显著增大,术后复发率显著增加.单因素分析显示饮酒、持续性房颤、2型糖尿病、CHADS2评分≥2、左心房扩大均与房颤消融术后复发显著相关.Cox多因素回归分析示,饮酒(HR=1.547,95％ CI 1.108～2.161,P=0.010),2型糖尿病(HR=1.939,95％CI 1.038 ～3.622,P=0.038),左心房内径(HR=1.046,95％ CI 1.000 ～1.095,P=0.050)是房颤消融术后复发的独立预测因素.结论大量饮酒的房颤患者左心房内径明显扩大,其消融术后的复发率显著增加.饮酒程度能够独立预测消融术后房颤的复发.
목적 탐토음주정도대남성심방전동(방전)환자도관소융후방전복발적영향.방법 공련속입선초차진행사빈소융치료적남성방전환자192례(지속성방전64례,진발성방전128례),평균년령(53.4± 10.3)세.배제환유판막성심장병、근3개월내발생심기경사、좌심실사혈분수(LVEF) ＜0.50、갑상선공능항진,이급엄중간신공능이상자.근거술전음주정도분위불음주、소중량음주화대량음주3조,병대비3조간림상특정급소융료효적차이.진행단인소급Cox다원회귀분석,평개방전소융술후복발적예측인소.결과 평균수방(17.7±6.1)개월,공66례(34.4％)환자복발방전.기중,대량음주자(29.7％)적좌심방내경현저증대,술후복발솔현저증가.단인소분석현시음주、지속성방전、2형당뇨병、CHADS2평분≥2、좌심방확대균여방전소융술후복발현저상관.Cox다인소회귀분석시,음주(HR=1.547,95％ CI 1.108～2.161,P=0.010),2형당뇨병(HR=1.939,95％CI 1.038 ～3.622,P=0.038),좌심방내경(HR=1.046,95％ CI 1.000 ～1.095,P=0.050)시방전소융술후복발적독립예측인소.결론 대량음주적방전환자좌심방내경명현확대,기소융술후적복발솔현저증가.음주정도능구독립예측소융술후방전적복발.
Objective The aim of this study was to evaluate the association of alcohol consumption with the outcome of AF ablation among Chinese men.Methods The study involved 192 consecutive Chinese men who underwent catheter ablation of AF (64 patients with persistent AF).Participants were categorized as non-drinkers,light or moderate drinkers,and heavy drinkers according to the amount of alcohol intake per week before the ablation.Results After a mean follow-up of ( 17.7±6.1 ) months (5 ～31 months),66 (34.4％) patients had recurrent AF after ablation.Heavy drinkers,found in 29.7％ of candidates for AF ablation,had a significantly larger left atrial(LA) size and a higher incidence of recurrent AF after ablation compared to nondrinkers and light or moderate drinkers.In addition,alcohol consumption ( HR=1.765,95％ CI 1.298 ～2.400,P＜0.001 ),persistent AF (HR=1.64,95％ CI 1.006 ～ 2.673,P=0.047 ),type 2 diabetes ( HR =2.409,95％ CI 1.332 ～4.385,P=0.004),CHADS2 score≥2 ( HR=2.0,95％ CI 1.090 ～3.672,P=0.025),dilated LA ( HR=1.073,95％ CI 1.027 ～ 1.120,P=0.002) were significantly associated with AF recurrence after the procedure.Multivariate Cox regression analysis revealed that alcohol consumption ( HR =1.547,95％ CI 1.108 -2.161,P=0.010),type 2 diabetes (HR=1.939,95％ CI 1.038 ～ 3.622,P=0.038) and LA size ( HR =1.046,95％ CI 1.000 ～ 1.095,P=0.050) were independent predictors of recurrent AF after ablation Conclusion Consuming heavier amounts of alcohol was associated with an increased risk of recurrent AF after catheter ablation among Chinese men.Alcohol consumption could independently predict the outcome of AF ablation.