Objective:We aim to investigate the association of neutrophil/lymphocyte ratio(NLR)with ambulatory blood pressure variability(BPV)and blood pressure circadian rhythm in patients with essential hypertension.Methods:We included patients with essential hypertension who were admitted in the First Center of Chinese PLA General Hospital during January 2020 to January 2021.NLR was defined as lymphocyte count divided by neutrophil count.We used standard deviation(SD),coefficient of variation(CV),and variation independent of mean(VIM)to evaluate the ambulatory BPV.We used multiple linear regression to examine the association between NLR and ambulatory BPV,and multivariable logistic regression to examine the association of NLR with non-dipping and reverse-dipping blood pressure.Results:A total of 936 patients with essential hypertension were included in the current study.After adjusting for potential confounders,we found positive linear association of NLR with 24h SBP SD(B=0.25),SBP-CV(B=0.98),SBP-VIM(B=0.15),DBP CV(B=1.23),diurnal SBP-SD(B=0.62),SBP-CV(B=l.11),SBP-VIM(B=0.30),DBP-CV(B=0.99),and nocturnal SBP-SD(B=0.69),SBP-CV(B=1.39),SBP-VIM(B=0.29),DBP-SD(B=1.54),DBP-CV(B=1.72),DBP-VIM(B=0.42).Multivariable logistic regression showed that compared with the lowest quartile of NLR,the highest quartile of NLR was associated with 93％higher risk of non-dipping and reverse-dipping blood pressure(OR=1.84,95％CI:1.84,1.11-3.03).Conclusions:NLR was positively and linearly associated with ambulatory BPV.Elevated NLR was associated with higher risk of non-dipping and reverse-dipping blood pressure.
To investigate the value of ventilation/perfusion (V/Q) scanning and CT pulmonary angiography (PA) in predicting CTEPH development after acute pulmonary embolism (APE). This study was performed in APE patients who had undergone both V/Q and CT PA after 3-month anticoagulation. The residual pulmonary obstructions were assessed based on V/Q and CT PA, and then recorded as pulmonary perfusion detect score (PPDs) and CT pulmonary artery obstruction index (PAOI). The predictive performance of PPDs and CT PAOI for CTEPH were determined and risk factors for predicting CTEPH development were identified. A total of 235 patients with initial diagnosis of APE were included in this study. ROC analysis showed that the AUCs of the PPDs and CT PAOI were 0.957 and 0.895, with corresponding cut-off values of 20.50% and 17.50% for predicting CTEPH development. Neither sensitivity nor specificity differed significantly between PPDs and CT PAOI (Sensitivity: 92.00% vs. 80.00%, P = 0.25; Specificity: 88.10% vs. 89.52%, P = 0.69). The univariable and multivariable logistic regression analysis demonstrated that pulmonary arterial hypertension confirmed by echocardiography at initial APE diagnosis (OR: 6.16, 95%CI: 1.31–29.02, P = 0.02), a PPDs of > 20.50% (OR: 22.95, 95%CI: 2.37–222.19, P = 0.007), and a CT PAOI of > 17.50% (OR: 9.98, 95%CI: 2.06–48.49, P = 0.004) were associated with CTEPH development. Both V/Q and CT PA after 3-month anticoagulation for APE showed great performance in predicting CTEPH development, and V/Q scanning has a tendency to be more sensitive but less specific than CT PA. The residual pulmonary embolism detected by V/Q and CT PA was associated with an increased risk of CTEPH development.
临床资料 李某,女,47岁,因反复颜面、双下肢浮肿7年入院.2014年,因颜面部、双下肢浮肿,外院诊断为"系统性红斑狼疮",间断服用醋酸泼尼松、硫酸羟氯喹等药物.后因呕血,量少,查全血细胞减少,调整治疗方案为"泼尼松15mg,每日1次,吗替麦考酚酯0.25g,每日2次,艾司奥美拉唑20mg,每日1次"治疗,全血细胞数恢复正常.
Objective:To study effect of ventricular septal hypertrophy and mitral valve related parameters of ultrasound-guided percutaneous intramyocardial septal radiofrequency ablation(PIMSRA)in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods:38 HOCM patients with PIMSRA therapy from January 2020 to December 2020 were retrospectively.then PIMSRA ablation,ventricular septal hypertrophy,mitral valve related indexes,and complications were observed.Preoperative and follow-up for 6 months,Used KCCQ assessment of HCOM patients'quality of life(physical limitations,self-evaluation,clinical symptoms,social functioning,self-knowledge,psychological status).Results:① HOCM patient LVEDD,lefct ventricular outflow tract(LVOT)higher than before surgery(P＜0.05).Anterior interval thickness,posterior interval thickness,left ventricular outflow tret peak grakient(LVOT-PG)lower than before surgery(P＜0.05).② Mitral regurgitation length,regurgitation area,regurgitation volume lower than that before surgery(P＜0.05).Peak early systolic velocity of Mitral annulus higher than before surgery(P＜0.05).No contraction mitral valve systolic anterior motion,(SAM)42.1％higher than before surgery 10.5％(P＜0.05).③ HOCM patients life quality dimensions and total score higher than that before surgery(P＜0.05).④ NYHA I rate 63.2％higher than before surgery 13.2％(P＜0.05).Chest tightness,chest pain,palpitations,vertigo rate lower than before surgery(P＜0.05).⑤ 1 case transient left bundle branch block,2 cases right bundle branch block.Conclusions:Ultrasound-guided PIMSRA can relieve the symptoms of ventricular Septal hypertrophy and Mitral regurgitation,and improve the cardiac function of patients with Hocm,then does not increase the risk of Arrhythmia.
以二尖瓣(mitral valve,MV)脱垂为特征的退行性二尖瓣反流(degenerative mitral regurgitation,DMR)是器质性MV疾病中最常见的类型,影响了全球约1.7％的人口[1].尽管DMR发病率很高,但对定量DMR瓣环和瓣叶动力学及对MV反流机制和严重程度的影响尚未得到足够的重视.到目前为止还没有标准化的DMR动物模型,二维超声心动图对MV三维结构的成像也还不够不完善[2].
Objective:To investigate the impact of continuous care on self-care ability,health behavior,cardiac function,and quality of life in hospital home self-care processes for patients with heart failure.Methods:A total of 153 patients with chronic heart failure who were treated in our hospital were divided into an experimental group and a control group after admission and treatment.The experimental group received 6 months of continuous care with the assistance of medical staff at the heart failure clinic,while the control group received 6 months of follow-up under routine care.After 6 months,a comprehensive follow-up was conducted to compare the changes in self-care ability,health behavior,heart function,and quality of life between the two groups of patients,including the ESEA score of the self-care scale,the HPLP score of healthy lifestyle,and the review of cardiac ultrasound,NYHA rating of heart function,and the minnesota heart failure quality of life questionnaire.Results:After a follow-up of 6 months,the self-care ability and health behavior of the two groups of patients were compared according to the scoring system.The results of ESEA score and HPLP score showed that the scores of the experimental group were higher than those of the control group,with a significant difference(P＜0.05);Comparing the recovery of cardiac function and quality of life between the two groups of patients,the quality of life scores of Class Ⅰ and Ⅱ patients in the experimental group were significantly higher than those in the control group(P＜0.05);The experimental group had a higher cardiac function score,with a significant difference compared to the control group(P＜0.05).Conclusions:Continuous intervention nursing has a positive promoting effect on the improvement of heart function and quality of life in hospital home self rehabilitation for heart failure patients.
Objective:To evaluate the myocardial protective effect of histidine-tryptophan-ketoglutarate solution(HTK)solution and cold blood-containing cardioplegia in patients with hypertrophic obstructive cardiomyopathy(HOCM)underwent surgical myectomy procedure.Methods:A retrospective analysis of adult patients undergoing surgical treatment of HOCM in cardiac surgery between January 2015 and December 2021 in Beijing Anzhen Hospital affiliated to Capital Medical University was conducted.The patients were divided into two groups according to the intraoperative use of cardioplegia:the HTK solution group(HG,n=200)and the blood-containing cardioplegia group(BG,n=1 18).Results:Five patients(1.6％)died in hospital,four patients(2.0％)were in the HG group and one patient(0.9％)was in the BG group,the difference was not statistically significant(P＞0.05).The time of aortic clamping[81(76,103)vs.76.6(49,88)min]and cardiopulmonary bypass[118.5(92,152)vs.112.5(78,134)min]in the HTK group were slightly longer,but the difference was not statistically significant(P＞0.05).The HTK solution group has a lower rate of the heart restarted spontaneously after declamping the ascending aortic(29.0％vs.56.8％,P＜0.01).The mean postoperative adrenaline use time was shorter in the HG group than in the BG group[15.7(0,18)vs.27.6(0,28)h,P=0.025].Compared with patients in the BG group,the duration of ICU stayed in the HG group was shorter[30.6(16.0,29.0)vs.40.9(18.0,38.5)h,P=0.015].Conclusions:Both HTK solution and blood-containing cardioplegia can be safely used in HOCM patients underwent surgical myectomy.Although the HTK solution group has a lower rate of the heart restarted spontaneously after declamping the ascending aortic,it can provide better myocardial protection and promote postoperative recovery.
Objective:The prevalence of metabolic syndrome(MS)is increasing every year,posing a serious risk to public cardiovascular health.Patients with ST-segment elevation myocardial infarction(STEMI)and MS tend to have a worse prognosis.However,there are no studies on the short-term prognosis of STEMI patients with MS in the Asian elderly population.Therefore,the purpose of this study was to explore the effect of MS on the occurrence of 30-day major adverse cardiovascular events(MACE)in the elderly Chinese STEMI population.Methods:The study was a single-center retrospective cohort study,and 325 elderly STEMI patients were finally enrolled.All patients were divided into two groups according to whether they had MS:no MS group(n=156)and MS group(n=169).Primary endpoint:30-day MACE,including all-cause mortality,recurrent myocardial infarction,cardiogenic shock and heart failure rehospitalization.Secondary endpoint:each component of MACE.The association between MS and 30-day MACE was explored by logistic regression analysis,and results were expressed using OR and 95％CI.The effect of MS on 30-day MACE in different subgroups was explored using subgroup analysis and plotted in forest plots,with results expressed as OR,95％CI and interaction P value.Results:In elderly patients with STEMI,the incidence of 30-day MACE was significantly higher in the MS group than in the no-MS group(no-MS group vs.MS group:12,7.7％vs.26,15.4％,P＜0.05),mainly due to cardiogenic shock(no-MS group vs.MS group:1,0.6％vs.15,8.9％,P＜0.05)and heart failure rehospitalization(no-MS group vs.MS group:2,1.3％vs.13,7.7％,P＜0.05).Multiple logistic regression analysis showed that the risk of MACE was significantly increased in the MS group compared with the no-MS group(OR=2.34,95％CI:1.09-5.05,P=0.030).In subgroup analysis,no significant interaction between MS and other risk factors was found.Conclusions:In elderly STEMI patients,MS was an independent risk factor for the development of 30-day MACE and significantly increased the risk of 30-day MACE.
Objective:To analyze the short-term and medium-term prognosis and the feasibility of triple valve repair in patients with rheumatic heart disease complicated with mitral,aortic,and tricuspid valve diseases.Methods:Between January 2015 and August 2022,93 patients with rheumatic heart disease underwent triple valve repair surgery at our center.The mean age of the patients was 54.7 years,and 65.6％were women.Each patient had obvious symptoms of rheumatic heart disease,and preoperative echocardiography evaluation showed that each patient had stenosis or regurgitation of triple valves,including severe mitral stenosis(58.1％,n=54)and severe mitral regurgitation(37.6％,n=35);severe aortic stenosis(2.2％,n=2)and severe aortic regurgitation(4.3％,n=4);and severe tricuspid regurgitation(20.4％,n=19).Results:The follow-up period was from 4 months to 96 months(median follow-up was 39 months),with a completion rate of 98.9％.There were no valve-related complications or deaths during hospitalization.During the follow-up period,3 patients died,and the 5-year survival rate was 97.8％.The freedom from severe valvular disease and valve-related complications were about 94.6％and 95.3％,respectively,after 5 years.Conclusions:Simultaneous repair of triple valves in rheumatic heart disease is feasible in experienced centers,and the short and medium postoperative mortality and incidence of valve-related complications are low.However,there is a certain risk of severe valvular disease in the long term.
Objective:To assess the impact of admission anemia on treatment modalities during hospitalization and clinical outcomes in patients with acute myocardial infarction(AMI).Methods:A total of 1 028 inpatients diagnosed with AMI from January 2016 to December 2018 in the Department of Cardiology,Nanchong Central Hospital.Comparison of the differences of revascularization therapy in patients with AMI with anemia and without anemia.Logistic regression models were used to estimate odds ratios of in-hospital adverse events stratified by anemia.Kaplan-Meyer plots assess differences in survival during follow-up.Cox regression model to calculate hazard ratio for all-cause mortality in anemia status.Results:AMI with mild anemia in 102 patients(9.9％)and moderate-severe anemia in 56 patients(5.5％).Compared with AMI patients without anemia,patients with anemia were less likely to choose interventional therapy(P＜0.05),the incidence rate of bleeding,total mortality,cardiogenic shock,heart failure,severe arrhythmia and stroke during hospitalization was significantly increased(P＜0.05).Logistic regression analysis showed that anemia was independently associated with adverse cardiovascular events,bleeding and death during hospitalization(P＜0.05).Kaplan-Meier plot showed that the survival rate of patients with anemia was significantly lower than that of patients without anemia(P＜0.05).Cox regression analysis showed that the hazard ratio of all-cause mortality was significantly increased in anemia status(P＜0.05).Conclusions:Admission anemia increases the risk of bleeding,adverse cardiovascular events,and death during hospitalization in patients with AMI,and adversely affects long-term survival after AMI.
Objective:The clinical characteristics of elderly patients with acute pulmonary embolism(APE)were analyzed to provide reference for early diagnosis.Methods:A total of 291 hospitalized APE patients in Xuanwu Hospital of Capital Medical University from January 2016 to December 2021 were selected and divided into 174 elderly patients and 117 non-elderly patients according to age.The differences of past history,clinical manifestations,laboratory indicators,simplified pulmonary embolism severity index(sPESI)scores,and bleeding conditions were compared between two groups.All patients were followed up for 30 days and 1 year,the differences in 30-day and 1-year all-cause mortality rates were compared between two groups.Results:BMI,proportion of patients with chest pain symptoms,lymphocyte count and D-dimer value in the elderly group were all lower than those in the non-elderly group(P＜0.05).The proportion,creatinine value and sPESI score of patients with hypertension,coronary heart disease,chronic bronchitis,cerebrovascular disease,arrhythmia,surgery and other underlying diseases were higher than those of non-elderly patients(P＜0.05).Follow up analysis showed that there was no statistically significant difference in the 30-day all-cause mortality rate between the two groups(P=0.129),but the 1-year all-cause mortality rate in the elderly group was significantly higher than that in the non-elderly group(33.3％vs.10.3％,P=0.001).Conclusion:Elderly APE patients have multiple underlying diseases,atypical symptoms,and high long-term mortality rates.
肺动脉异常起源于升主动脉(anomalous origin of pulmonary artery from ascending aorta,AOPA)是一种十分罕见的先天性心脏病,可分为单侧肺动脉缺如、单侧肺动脉起源异常、肺动脉吊带三种类型[1],Fraentzel在1868年首次描述了这种异常起源,迄今文献报道的AOPA病例约300余例,且主要是婴幼儿多见,成人病例相对罕见.
Objective:Aortic surgery and cardiopulmonary bypass are both associated with development of postoperative acute kidney injury.In this study,we undertook to investigate the relationship between cardiopulmonary bypass duration and postoperative acute kidney injury in patients undergoing aortic surgery for Stanford type A aortic dissection.Methods:All patients receiving aortic surgery for Stanford type A aortic dissection in Beijing anzhen hospital from December 2015 to April 2017 were included.Cardiopulmonary bypass duration was recorded during surgery.Acute kidney injury was defined based on the Kidney Disease Improving Global Outcomes criteria.Results:A total of 817 consecutive patients were eventually analyzed.The overall incidence of acute kidney injury was 37.3％(n=305).The average age was(48.3±11.4)years;73％were male.Mean cardiopulmonary bypass duration was(200.1±51.3)min.In-hospital mortality was 8.6％.Multivariate Logistic regression revealed that cardiopulmonary bypass duration was independently associated with the occurrence of postoperative acute kidney injury after adjust confounding factors(OR=1.006,95％CI:1.001-1.011,P=0.020).Conclusions:Cardiopulmonary bypass duration is independently associated with an increased hazard of acute kidney injury after aortic surgery or Stanford type A aortic dissection.Further understanding of the mechanism of this association is crucial to the design of preventative strategies.
Objective:To investigate the relationship between plaque types,properties,serum markers and prognosis in patients with coronary heart disease(CHD)evaluated by coronary artery CTA.Methods:A total of 218 patients with coronary heart disease treated in our hospital from June 2019 to June 2021 were collected as the research objects.According to the different CT values obtained by CTA examination,all patients were divided into calcified plaque group(CT value＞130HU,n=48)and mixed plaque group(CT value 60-130HU,n=121)and soft plaque group(CT value＜60HU,n=49).The degree of coronary artery stenosis,serum marker level and incidence of major adverse cardiovascular events(MACE)were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of coronary CTA plaque CT values for MACE during the follow-up period.Results:There was a significant difference in the distribution of coronary artery stenosis between calcified plaque group,mixed plaque group and soft plaque group(P＜0.05).The levels of serum NT-proBNP,monocyte chemoattractant protein 1(MCP-1)and fractalkine(FKN)of patients in calcified plaque group,mixed plaque group and soft plaque group increased successively after admission,and the differences between the two groups were statistically significant(P＜0.05).The incidence of MACE in calcified plaque group,mixed plaque group and soft plaque group increased successively during the follow-up period,and the differences between the two groups were statistically significant(P＜0.05).Univariate and multivariate logistic regression analysis showed that soft plaque and severe coronary artery stenosis were independent risk factors for MACE(P＜0.05).ROC curve showed that the best cutoff value of plaque CT value obtained from coronary CTA after admission to predict the occurrence of MACE during the follow-up period was 78.41 HU,AUC=0.846,95％CI:0.772-0.920,and the corresponding sensitivity and specificity were 80.39％and 70.59％respectively.Conclusions:The evaluation of plaque properties by CT value of coronary CTA plaque is closely related to the degree of coronary stenosis and the level of serum markers,and has a positive role in predicting the occurrence of MACE.
抗生素耐药性是世界上最紧迫的公共卫生问题之一,如果抗生素失去原有的临床价值,那么我们就失去了治疗感染和控制这些公共卫生威胁的能力.2019年美国疾病预防与控制中心(centers for disease control and prevention,CDC)公布了抗生素耐药威胁报告,该报告根据细菌耐药性威胁不同将18种细菌分类为:紧急威胁、严重威胁和令人担忧,以及一些观察名单[1].
肥厚型心肌病(hypertrophic cardiomyopathy,HCM)是由肌节基因突变引起的遗传性心肌病.其主要特征是左心室(left ventricle,LV)非对称或对称性肥厚,常伴有左心室流出道梗阻(LV outflow tract obstruction,LVOTO)、室性心律失常和进展性心力衰竭[1].HCM也是导致年轻人心源性猝死和老年人心力衰竭的重要原因,因此早期准确诊断和识别风险程度对于预防威胁生命事件的发生具有重要意义[2].
Objective:To investigate the diagnostic value of transthoracic echocardiography(TTE)for cardiogenic embolus in embolic stroke patients,and to analyze the predictive value of TTE parameters for prognosis.Methodss:A retrospective analysis was performed on 200 patients with embolic stroke admitted to our hospital from January 2012 to January 2022.Transesophageal echocardiography(TEE)and surgical results were used as the gold standard to analyze the diagnostic value of TTE for cardiogenic embolus,and to observe the imaging characteristics of TTE.After 1-year follow-up,the patients were divided into survival group and death group according to the prognosis.The LAD,LVESD,LVEDD,LVEF and interventricular septal thickness(IVST)of the two groups at admission were compared,and the predictive value of TTE parameters on the prognosis of the patients was analyzed.Results:The analysis indicated that the diagnosis coincidence rates of patent foramen ovale(PFO)detected by TTE,left atrial/left auricular thrombi,left ventricular hypertrophy,left atrial myxoma,left atrial enlargement and heart growth were 82.2％,82.2％,93.8％,84.2％,93.3％and 87.5％,respectively.Among the misdiagnosed patients,left atrial myxoma was misdiagnosed in 2 cases and left atrial enlargement in 1 case.Among the missed patients,13 cases of PFO were missed,8 cases of left atrial/left atrial ear thrombosis was missed,2 cases of left ventricular hypertrophy was missed,1 case of left atrial myxoma was missed,and 2 cases of cardiac neoplasm were missed.Follow-up results:Among 200 patients,161(80.5％)survived and 39(19.5％)died.LAD,LVESD and LVEDD in survival group were lower than those in death group,and LVEF was higher than those in death group(P＜0.05).The AUC of LAD,LVESD,LVEDD and LVEF independently predicted the prognosis of CES patients were 0.737,0.766,0.788 and 0.807,and the AUC of the four combined predictions was 0.873.The specificity of the four combined predictions was 92.6％,higher than that of LAD(62.7％),LVESD(78.9％),LVEDD(77.0％)and LVEF(77.0％)alone(P＜0.05).Conclusions:TTE has certain value in the detection of cardiogenic emboli in patients with embolic stroke,which can timely clarify the characteristics of patients with cardiogenic emboli,and has predictive value for the prognosis of patients.
Objective:To investigate the predictive ability of cardiac magnetic resonance imaging(MRI)for adverse cardiovascular events in peripartum cardiomyopathy(PPCM),and to provide a basis for early identification of high-risk patients.Methods:Patients who were diagnosed as PPCM and underwent enhanced cardiac MRI were retrospectively enrolled.Patients were followed up via clinic or telephone.The primary endpoints were major adverse cardiovascular events,including cardiac related death,heart transplantation,hospitalization for heart failure,life-threatening arrhythmia,pulmonary embolism or systemic embolism.Patients were divided into event group or non-event group based on whether adverse events have occurred.COX regression analysis were used to investigate the association between MRI parameters and adverse events.Results:A total of 29 patients with PPCM were included,with an average age of 33 years.Nine patients had primary endpoints during the follow-up period.There was no statistically significant difference in pregnancy between the two groups.Nine(31％)patients were LGE positive,and LGE percent in the event group were higher than those in the non-event group(P=0.03).The global longitudinal strain(GLS)and global circumferential strain(GCS)decreased more significantly in the event group GCS:[(-8.7±1.9)％vs.(-7.1±1.6)％,P=0.03];GLS:[(-7.7±2.1)％vs.(-5.9±1.4)％,P=0.02].Univariate Cox analysis showed that LVEF,LGE percent,GCS and GLS were associated with adverse cardiovascular events.Conclusions:LVEF,LGE,GCS,and GLS are associated with adverse cardiovascular events.Cardiac magnetic resonance imaging is a potential tool for risk stratification in patients with PPCM.
患者男,33岁,活动后气促5年余,加重伴咳血3个月.15d前曾出现黑便,伴晕厥一次,急诊血常规提示血红蛋白45g/L,予以输血处理后缓解.患者无明确的遗传病史.查体:轻度贫血貌,下肢皮肤多发斑疹,心律齐,肺动脉瓣区第二心音亢进.超声心动图示:右心房内径5.8 cm,右心室基底段左右径5.6 cm,主肺动脉内径4.4 cm,右肺动脉内径2.1 cm,左肺动脉内径2.2 cm,三尖瓣反流峰速4.7 m/s,估测肺动脉压 95 mmHg(1 mmHg=0.133 kPa)(图1A),三尖瓣环收缩期运动幅度(tricuspid annular plane systolic excusion,TAPSE):1.4 cm,右心室面积变化率(right ventricular fractional area change,RVFAC):35％.
Objective:To observe the mitral annular calcification(MAC)in patients with atrial fibrillation and then investigate the relationship between MAC and recurrence after radiofrequency ablation.Methods:This study included 785 patients who were hospitalized for radiofrequency ablation of atrial fibrillation at the Department of Cardiology,Beijing Anzhen hospital from 2019.1.1 to 2020.12.31,and were divided into MAC group and no MAC group according to preoperative echocardiography.There were 102 cases in the MAC group and 683 cases in the no MAC group.The mean follow-up was 16 months to observe the recurrence of atrial fibrillation in both groups.The recurrence rate after radiofrequency ablation of atrial fibrillation was calculated by Kaplan-Meier survival analysis.Results:Among patients with atrial fibrillation undergoing radiofrequency ablation,patients in the MAC group were older,69％of which were female,had a higher prevalence of previous hypertension and diabetes mellitus,a larger LAD,a higher incidence of moderate to severe mitral regurgitation,and a higher CHA2DS2-VASc score.Besides,there is a higher recurrence rate after radiofrequency ablation of atrial fibrillation in patients with MAC than in those without MAC(36％vs.22％,P=0.002).Kaplan-Meier survival curves showed a higher recurrence rate after radiofrequency ablation in patients with MAC compared with patients with atrial fibrillation without MAC.Conclusions:The presence of MAC in patients with atrial fibrillation is significantly associated with recurrence after radiofrequency ablation.
