Pulmonary vein variants predispose to atrial fibrillation: a case-control study using multislice contrast-enhanced computed tomography
Pulmonary vein variants predispose to atrial fibrillation: a case-control study using multislice contrast-enhanced computed tomography
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DOI：
10.1093/europace/eur145
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发表时间：
2011-10-01
期刊：
影响因子：
6.1
通讯作者：
Eckardt, Lars
中科院分区：
文献类型：
--
作者：
Bittner, Alex;Moennig, Gerold;Eckardt, Lars
目的肺静脉（PV）在心房颤动（AF）中起着关键作用. PV的解剖变异已被描述，并与更高的致瘤潜力相关。本研究的目的是比较的患病率的PV变量和直径的PV口AF patients and controls.Methods和结果的PV变量被定义为右或左共同口（RCO，LCO），右中或右上PV。长共同干（LCT）定义为LCO与第一个分支的距离>= 10 mm。166例连续患者在房颤消融前进行多层对比增强胸部计算机断层扫描，其中47.6%为阵发性房颤，52.4%为持续性房颤，以及性别和年龄匹配的对照组，无房颤，用于非心脏适应症。由两名独立观察员评价图像。平均年龄为59 ± 10岁，108例为男性（65.1%）。AF组的LCO患病率更高：33.7% vs. 19.9%（P = 0.004），比值比（OR）2.1; 15.4%的患者vs 10.2%的对照组有LCT（P = 0.14）。AF患者肺静脉开口直径大于对照组（P <0.001.Conclusions据我们所知，本研究首次显示AF患者LCO的患病率高于对照组，OR为2.1。这表明LCO在AF的发展中具有诱发作用。
Aims Pulmonary veins (PV) play a pivotal role in atrial fibrillation (AF). Anatomical variants of PV have been described and related to a higher arrhythmogenic potential. The aim of this study was to compare the prevalence of PV variants and diameters of PV ostia in AF patients and controls.Methods and results Variants of PV were defined as right or left common ostia (RCO, LCO), a right middle or right top PV. A long common trunk (LCT) was defined as an LCO with a distance to the first branching >= 10 mm. Multislice contrast-enhanced thoracic computed tomography was performed prior to AF ablation in 166 consecutive patients, 47.6% with paroxysmal, 52.4% with persistent AF, as well as in a sex- and age-matched control group without AF, for non-cardiological indications. Images were evaluated by two independent observers. The mean age was 59 +/- 10 years, 108 were men (65.1%). A higher prevalence of LCO was found in the AF group: 33.7 vs. 19.9% (P = 0.004), odds ratio (OR) 2.1; 15.4% in patients vs. 10.2% in controls had an LCT (P = 0.14). No differences in other PV variants were found. The ostial diameters were greater in AF-patients (P < 0.001).Conclusions To the best of our knowledge, the present study shows for the first time a higher prevalence of an LCO in patients with AF as compared with controls, with an OR of 2.1. This suggests a pre-disposing role of LCO in the development of AF.