在患有透支功能障碍的患者中,静止心率和发生性心房动
Stefan Preisendörfer1, Virginia Singla1, Aditya Bhonsale1
1Heart and Vascular Institute, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
The American journal of cardiology
|March 10, 2024
概括
休息心率 (RHR) 影响心房动 (AF) 风险在患有透静功能障碍 (DD) 的患者. 缓慢和快速的RHR都会增加AF住院的风险,这表明J形关系. 需要进一步的试验来探索RHR修改策略.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 透支功能障碍 (DD) 是发生性心房动 (AF) 的已知危险因素.
- 静止心率 (RHR) 对DD患者发生的AF的具体影响仍未得到充分研究.
- 了解这种关系对于风险分层和风险管理至关重要.
研究的目的:
- 调查RHR对被诊断为DD的患者的AF发生率的影响.
- 确定RHR是否影响该患者群体中AF住院的风险.
主要方法:
- 从一个大型医疗系统对19046名DD患者和没有先前AF病史的回顾性分析.
- 根据RHR (<66,66-76,77-91,>91bpm) 患者被分为四分之一.
- 事件AF通过AF住院进行评估,使用Cox比例危险模型计算AF住院和全因死亡率的危险比率 (HR),调整为混因素.
主要成果:
- 在42.2个月的中位数随访期间,3.9%的患者因AF住院.
- 在RHR和AF住院风险之间观察到J形关联,较慢的 (HR 1.40) 和更快的 (HR 1.72) RHR四分位数与参考四分位数相比显著增加了风险.
- 所有原因的死亡率都显示出随着更快的RHR (HR 1.19每四分位数增加) 的逐步增加.
结论:
- 这项大规模分析显示,较低和较高的RHR都与DD患者发生事件AF的风险增加有关.
- 这些发现表明,在这个队列中,与RHR相关的AF发病率具有潜在的J形风险曲线.
- 需要进一步的随机试验来探索修改RHR的治疗潜力,以减少DD患者的AF风险.
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