上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

心肌纤维化与冠脉搭桥术后心房颤动发生的关系研究

樊永亮，毛建强，庄瑜，袁忠祥   

  1. 上海交通大学附属上海市第一人民医院心血管外科， 上海 200080
  • 出版日期:2016-03-28 发布日期:2017-06-02
  • 通讯作者: 袁忠祥, 电子信箱: yuanzx828@163.com。
  • 作者简介:樊永亮（1979—）， 男， 硕士生; 电子信箱: fanyl1998@163.com。

Correlation of atrial fibrosis and atrial fibrillation after coronary artery bypass grafting

FAN Yong-liang, MAO Jian-qiang, ZHUANG Yu, YUAN Zhong-xiang   

  1. Department of Cardiovascular Surgery, the First Peoples Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
  • Online:2016-03-28 Published:2017-06-02

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摘要：

目的 探讨心房心肌纤维化与冠脉搭桥术后心房颤动发生的关系。方法 根据冠脉搭桥术后是否发生心房颤动，将47例冠状动脉粥样硬化性心脏病患者分为心房颤组（房颤组）和未发生心房颤动组（对照组）。在术中体外循环前留取右心耳标本。Masson染色后对标本中胶原纤维含量进行半定量测量，计算心房组织心肌胶原容积分数(CVF)，评价心肌纤维化程度。结果 47例冠脉搭桥患者术后有15例发生心房颤动，发生率为31.9%。47例患者心肌CVF平均为21.6%±8.1%（4.1%~39.1%）。分组分析结果显示：房颤组患者的年龄显著大于对照组（P=0.032）；房颤组和对照组心肌CVF分别为25.4%±7.9%和19.9%±7.7%，房颤组显著高于对照组（P=0.020）；两组患者其他术前资料及术中和术后情况无明显差异。相关性分析结果显示患者年龄与心肌CVF显著相关（r=0.876,P=0.007）。结论 年龄与心肌纤维化程度明显相关，心房心肌纤维化与冠脉搭桥术后心房颤动的发生相关。心肌纤维化可能是冠脉搭桥术后心房颤动发生的重要机制之一。

关键词: 冠脉搭桥术, 心房颤动, 心肌纤维化

Abstract:

Objective To investigate the correlation between atrial fibrosis and atrial fibrillation after coronary artery bypass grafting (CABG). Methods Forty-seven patients with coronary atherosclerotic heart disease were assigned to the atrial fibrillation group and non-atrial fibrillation group (control group) according to whether atrial fibrillation occurred after CABG. Right atrial appendage sample was harvested before cardiopulmonary bypass. Collagen fiber content in samples was semi-quantitatively measured after Masson staining. Myocardial collagen volume fraction (CVF) in atrial tissues was calculated and atrial fibrosis was assessed. Results Among 47 patients undergoing CABG, 15 (31.9%) of them developed postoperative atrial fibrillation. Myocardial CVF was 21.6%±8.1% (4.1%-39.1%). Analysis by group showed that the age in the atrial fibrillation group was significantly older than that in the control group (P=0.032). Myocardial CVFs in the atrial fibrillation group and the control group were 25.4%±7.9% and 19.9%±7.7%, respectively. Myocardial CVF in the atrial fibrillation group was significantly higher than that in the control group (P=0.020). The differences in other preoperative, intraoperative and postoperative data between two groups were not markedly. Correlation analysis showed that the age of patients was significantly correlated to myocardial CVF (r=0.876, P=0.007). Conclusion The age is significantly correlated to atrial fibrosis and atrial fibrosis is correlated to atrial fibrillation after CABG. Atrial fibrosis may be one of important mechanisms of developing atrial fibrillation after CABG.

Key words: coronary artery bypass grafting, atrial fibrillation, atrial fibrosis