Objective: To investigate the predictive value of neutrophils-to-lymphocytes ratio (NLR) for atrial fibrillation recurrence after radiofrequency ablation in atrial fibrillation patients combined with heart failure. Methods: This is a retrospective cohort study. Patients with atrial fibrillation and heart failure who received radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2019 to June 2020 were included. Patient were followed up in the outpatient clinic at 3, 6, 9 and 12 months after radiofrequency ablation and were divided into recurrent and non-recurrent groups according to the absence or presence of atrial fibrillation. Demographic data, echocardiographic indices and inflammation-related indices including NLR were collected and compared between the two groups. Spearman rank correlation was performed to analyze the correlation of NLR with atrial fibrillation recurrence after radiofrequency ablation. Multivariate logistic regression analysis was used to determine independent risk factors of atrial fibrillation recurrence after radiofrequency ablation. The receiver operating characteristic (ROC) curve was used to evaluate the value of NLR in predicting the atrial fibrillation recurrence after radiofrequency ablation. Results: A total of 883 patients were included, of which 460 (52.1%) were male, mean age was (64.4±10.7) years old. There were 246 patients (27.9%) in the recurrence group and 637 patients (72.1%) in the non-recurrence group. Compared with the non-recurrent group, the duration of atrial fibrillation, NLR, neutrophil count, N-terminal B-type natriuretic peptide precursor (NT-proBNP) and body mass index levels were significantly higher, while lymphocyte count was significantly lower in the recurrence group than in the non-recurrent group (all P<0.05). Spearman rank correlation analysis showed that NLR was positively correlated with the atrial fibrillation recurrence (r=0.333, P<0.05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for atrial fibrillation recurrence after radiofrequency ablation in atrial fibrillation patients combined heart failure (OR=1.634, P<0.001). The ROC curve showed that the area under the curve (AUC) of NLR in predicting the recurrence of atrial fibrillation after radiofrequency ablation was 0.715 (95%CI: 0.668-0.762, P<0.001), with a sensitivity of 55.61% and a specificity of 84.54%. Conclusion: NLR is a useful predictor of atrial fibrillation recurrence after radiofrequency ablation in atrial fibrillation patients combined with heart failure.
目的： 探讨中性粒细胞与淋巴细胞比值（NLR）对心房颤动（房颤）伴心力衰竭（心衰）患者射频消融术后房颤复发的临床预测价值。 方法： 该研究为回顾性队列研究。选取2019年1月至2020年6月于郑州大学第一附属医院接受射频消融术的房颤伴心衰患者，术后3、6、9、12个月门诊随访，根据随访期间房颤是否复发将患者分为复发组和非复发组。收集并比较2组患者的人口学资料、超声心动图检查指标和NLR等炎症相关指标。采用Spearman秩相关分析NLR与射频消融术后房颤复发的相关性，采用多因素logistic回归分析NLR对射频消融术后房颤复发的影响，采用受试者工作特征（ROC）曲线评价NLR对射频消融术后房颤复发的预测价值。 结果： 共纳入883例患者，男性460例（52.1%），年龄为（64.4±10.7）岁。房颤复发组246例（27.9%），非复发组637例（72.1%）。复发组中房颤病程、NLR、中性粒细胞计数、N末端B型利钠肽原、体重指数均高于非复发组，淋巴细胞计数低于非复发组（P均<0.05）。Spearman秩相关分析结果显示NLR与房颤复发呈正相关（r=0.333，P<0.05）。多因素logistic回归方程分析示，NLR是房颤伴心衰患者射频消融术后房颤复发的危险因素（OR=1.634，P<0.001）。ROC曲线示NLR预测房颤伴心衰患者射频消融术后房颤复发的曲线下面积为0.715（95%CI：0.668~0.762，P<0.001），灵敏度为55.61%，特异度为84.54%。 结论： NLR对房颤伴心衰患者射频消融术后房颤的复发有着较好的预测价值。.