在PR间隔延长或一级心房静脉阻塞患者的长期结果
Susan Cheng1, Michelle J Keyes, Martin G Larson
1Framingham Heart Study, Framingham, Massachusetts, USA.
JAMA
|June 25, 2009
概括
延长PR间隔,这是一种第一级心房阻塞的迹象,显著增加了心房动 (AF) 的风险,心脏起器植入,以及 ambulatory个体的全因死亡率.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 预防医学 预防医学
背景情况:
- 一级心房阻塞,定义为超过200毫秒的PR间隔,是一种常见的心电图发现.
- 在无症状个体中PR延长的临床意义需要进一步阐明.
研究的目的:
- 调查PR间隔延长在社区基队列中的长期临床影响.
- 评估PR延长与心房动,心脏起器植入和全因死亡率的发生率之间的关联.
主要方法:
- 来自弗雷明汉心脏研究的7575名个体的前性,基于社区的队列研究.
- 基线12心电图与PR间隔评估.
- 通过使用多变量调整的考克斯比例危险模型,在2007年之前的后续行动.
主要成果:
- 个人与PR间隔>200毫秒有显著更高的心房动 (AF) 的发病率,心脏起器植入,和所有原因的死亡率.
- 每增加20毫秒的PR间隔都与AF,心脏起器植入和全因死亡率的调整后危险比率增加有关.
- 一级心房静脉阻塞使调整后的AF风险增加了2倍,心脏起器植入风险增加了3倍,全因死亡风险增加了1.4倍.
结论:
- PR间隔延长是心血管不良结果的重要独立预测因素.
- 识别长时间PR间隔的个体可以帮助风险分层和预防策略.
- 这一发现强调了心电图评估在常规临床实践中的重要性.
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