过期引发的鼻节律失常预测了一般老年人群的死亡风险
Ralf Josef Dirschinger1,2, Alexander Müller1, Alexander Steger1
1Department of Internal Medicine I, University Hospital rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany.
Journal of cardiovascular development and disease
|February 25, 2025
概括
减少过期触发的鼻节律失常 (ETA) 预测了老年人的死亡率. 这种心率变化指标,与弗雷明汉得分相结合,可改善一般老年人群全因死亡风险分层.
科学领域:
- 心脏病学 心脏病学
- 老年学是一门学科.
- 生理学 生理学 生理学
背景情况:
- 减轻的呼吸道鼻律不整,量化为 expiration-triggered sinus arrhythmia (ETA),是已知的心肌梗塞幸存者的死亡预测因子.
- 在一般老年人群中,ETA的预测价值仍然不太清楚.
研究的目的:
- 调查ETA是否预测一般老年人群的死亡风险.
- 评估ETA是否补充现有的临床风险评分来预测死亡率.
主要方法:
- 从30分钟的心电图和呼吸记录中量化了1788名年龄≥60岁的个体的ETA.
- 随访参与者平均4.0年,以确定所有原因的死亡率.
- 利用多变量考克斯分析,并将ETA与风险分层的修改后的弗雷明汉分数结合起来.
主要成果:
- 在研究队列中,四年全因死亡率为4.6%.
- 异常的ETA (≤0.19毫秒) 与4年死亡率的增加显著相关 (6.9%对3.7%,p=0.0022).
- ETA仍然是一个独立的死亡率预测指标 (HR 1.81,p=0.008),并与弗雷明汉得分相结合,改善了风险分层,识别了具有明显死亡率的低,中,高风险群体 (1.9%,4.4%,10.1%).
结论:
- 在一般老年人群中,ETA是所有原因死亡率的重要预测指标.
- ETA为经典临床风险因素提供增量价值,增强老年人死亡风险分层.
- 测量ETA提供了一种非侵入性方法来补充现有的心血管风险评估.
相关概念视频
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
164
Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
164
01:14Decreased pulse rate
529
Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
529
01:28Disturbances in Heart Rhythm
860
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
860
01:28Mechanism of Cardiac Arrhythmias
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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
872
01:17Increased pulse rate
635
Tachycardia is a condition marked by an abnormally fast or irregular heart rate, surpassing the typical resting rate. In adults, tachycardia is characterized by a pulse rate ranging from 100 to 180 beats per minute. The increased heart rate can result in inadequate blood flow to various body parts, ultimately diminishing the oxygen supply to organs and tissues.
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
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01:12Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
886