在没有心房动病史的患者中,心房间际阻塞与心血管不良结果的关联
Joshua Lampert1, David Power2, Shreyas Havaldar3
1Helmsley Electrophysiology Center, Mount Sinai Hospital, New York, New York, USA. Electronic address: https://twitter.com/joshuamlampertmd.
JACC. Clinical electrophysiology
|June 24, 2023
概括
在没有心房动或心房动 (AF/AFL) 病史的患者中,心房间际阻塞 (IAB) 独立增加了中风风险. 这种关联甚至在考虑事件AF/AFL时也存在,即使没有发现心律失常,也突出显示了显著的风险.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 公共卫生 公共卫生
背景情况:
- 心脏间阻塞 (IAB) 与血栓栓塞和心脏节律失常有关.
- 关于IAB对不良结果的预测价值的先前研究,特别是在心房/心房 (AF/AFL) 患者中,仅限于小队列.
研究的目的:
- 在一大群患者中调查心脏间阻塞 (IAB) 和中风风险之间的关联.
- 确定IAB是否预测心房动/心房动 (AF/AFL) 的存在或不存在的不良结果.
主要方法:
- 追溯分析了来自5个中心的1,228,291名患者的4,837,989张心电图 (ECG).
- IAB定义为P波持续时间≥120 ms. 分析排除了以前有AF/AFL的患者.
- 使用受限平均存活时间和受限平均损失时间分析的结果.
主要成果:
- 在分析的队列中有19.6% (86,317名患者) 存在IAB.
- IAB独立地与中风增加的概率 (RMTLRC: 1.43),死亡率 (RMTLRC: 1.14),心力衰竭 (RMTLRC: 1.94) 和全身血栓塞栓症 (RMTLRC: 1.62) 相关.
- 在患有先前AF/AFL的患者中,IAB与中风无关.
结论:
- 在没有AF/AFL病史的患者中,心间阻塞是中风的独立预测因子.
- 即使对发生的AF/AFL和CHA2DS2-VASc得分进行调整后,IAB和中风风险之间的关联仍然很重要.
- 患有IAB的患者面临高的中风风险,即使没有检测到AF/AFL.
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