医学
射血分数
心脏病学
内科学
心房颤动
导管消融
心力衰竭
置信区间
优势比
队列
相伴的
烧蚀
QRS波群
作者
Marco Bergonti,Ciro Ascione,Lorenzo Marcon,Thomas Pambrun,Domenico G. Della Rocca,T Gonzalez Ferrero,Luigi Pannone,Michael Kühne,Paolo Compagnucci,Alice Bonomi,Andreas B. Gevaert,Matteo Anselmino,Michela Casella,Philipp Krisai,Claudio Tondo,Moisés Rodríguez‐Mañero,Nicolas Derval,Gian‐Battista Chierchia,Carlo de Asmundis,Hein Heidbüchel,Pierre Jaı̈s,Andrea Sarkozy
标识
DOI:10.1093/eurheartj/ehad428
摘要
Abstract Aims Management of patients with atrial fibrillation (AF) and concomitant heart failure (HF) remains complex. The Antwerp score, based on four parameters [QRS >120 ms (2 points), known aetiology (2 points), paroxysmal AF (1 point), severe atrial dilation (1 point)] adequately estimated the probability of left ventricular ejection fraction (LVEF) recovery after AF ablation in a single-centre cohort. The present study aims to externally validate this prediction model in a large European multi-centre cohort. Methods and results A total of 605 patients (61.1 ± 9.4 years, 23.8% females, 79.8% with persistent AF) with HF and impaired LVEF (<50%) undergoing AF ablation in 8 European centres were retrospectively identified. According to the LVEF changes at 12-month echocardiography, 427 (70%) patients fulfilled the ‘2021 Universal Definition of HF’ criteria for LVEF recovery and were defined as ‘responders’. External validation of the score yielded good discrimination and calibration {area under the curve 0.86 [95% confidence interval (CI) 0.82–0.89], P < .001; Hosmer–Lemeshow P = .29}. Patients with a score < 2 had a 93% probability of LVEF recovery as opposed to only 24% in patients with a score > 3. Responders experienced more often positive ventricular remodelling [odds ratio (OR) 8.91, 95% CI 4.45–17.84, P < .001], fewer HF hospitalizations (OR 0.09, 95% CI 0.05–0.18, P < .001) and lower mortality (OR 0.11, 95% CI 0.04–0.31, P < .001). Conclusion In this multi-centre study, a simple four-parameter score predicted LVEF recovery after AF ablation in patients with HF and discriminated clinical outcomes. These findings support the use of the Antwerp score to standardize shared decision-making regarding AF ablation referral in future clinical studies.
科研通智能强力驱动
Strongly Powered by AbleSci AI