Clinical, Electrocardiographic, and Echocardiographic Parameter Combination Predicts the Onset of Atrial Fibrillation
Clinical, Electrocardiographic, and Echocardiographic Parameter Combination Predicts the Onset of Atrial Fibrillation
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DOI：
10.1253/circj.cj-17-0758
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发表时间：
2018-09-01
影响因子：
3.3
通讯作者：
Sata, Masataka
中科院分区：
文献类型：
--
作者：
Soeki, Takeshi;Matsuura, Tomomi;Sata, Masataka
背景：识别新发心房颤动(房颤)危险标记物的能力对于制定预防策略至关重要，但临床、心电图和超声心动图参数的组合是否能预测房颤的发生尚不清楚。在这项研究中，我们评估了包含这些参数的综合评分的预测价值。方法和结果：我们回顾了2005年5月至2010年12月期间接受超声心动图和24小时加温心电图检查的1040名无房颤患者。在68.4个月(IQR，49.9-93.3个月)的中位随访期内，我们调查了新发房颤的发生率。在1040例患者中，103例(9.9%)发生了房颤。发生房颤的患者比没有发生房颤的患者年龄更大。24小时心电图上量化的总心率、房性早搏(PAC)计数、最大RR间期和窦性停顿频率与新发房颤相关。超声心动图上的左房内径(LAD)与房颤的发生有关。多因素COX分析显示，年龄58岁、PAC计数80次/天、RR间期最大值1.64s、左房下移4.5 cm与房颤的发生独立相关。结论：包括年龄、PAC计数、最大RR间期和LAD在内的综合评分有助于表征新发房颤的风险。
Background: The ability to identify risk markers for new-onset atrial fibrillation (AF) is critical to the development of preventive strategies, but it remains unknown whether a combination of clinical, electrocardiographic, and echocardiographic parameters predicts the onset of AF. In the present study, we evaluated the predictive value of a combined score that includes these parameters.Methods and Results: We retrospectively studied 1,040 patients without AF who underwent both echocardiography and 24-h Hotter electrocardiography between May 2005 and December 2010. During a median follow-up period of 68.4 months (IQR, 49.9-93.3 months), we investigated the incidence of new-onset AF. Of the 1,040 patients, 103 (9.9%) developed AF. Patients who developed AF were older than patients who did not. Total heart beats, premature atrial contraction (PAC) count, maximum RR interval, and frequency of sinus pause quantified on 24-h electrocardiography were associated with new-onset AF. LA diameter (LAD) on echocardiography was also associated with the development of AF. On multivariate Cox analysis, age >= 58 years, PAC count >= 80 beats/day, maximum RR interval >= 1.64s, and LAD >= 4.5cm were independently associated with the development of AF. The incidence rate of new-onset AF significantly increased as the combined score (i.e., the sum of the risk score determined using hazard ratios) increased.Conclusions: A combined score that includes age, PAC count, maximum RR interval, and LAD could help characterize the risk of new-onset AF.