Association of Longitudinal Changes in Cardiac Biomarkers With Atrial and Ventricular Arrhythmias (from the Atherosclerosis Risk in Communities [ARIC] Study).
Association of Longitudinal Changes in Cardiac Biomarkers With Atrial and Ventricular Arrhythmias (from the Atherosclerosis Risk in Communities [ARIC] Study).
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DOI：
10.1016/j.amjcard.2021.07.043
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发表时间：
2021-11-01
期刊：
影响因子：
--
通讯作者：
Chen LY
中科院分区：
文献类型：
--
作者：
Garg PK;Norby FL;Wang W;Krishnappa D;Soliman EZ;Lutsey PL;Selvin E;Ballantyne CM;Alonso A;Chen LY
我们评估了N末端B型利钠肽原（NT-proBNP）和高敏心肌肌钙蛋白T（hs-cTnT）循环水平的纵向变化与2周动态心电图监测所捕获的心律失常负荷的相关性。本研究纳入了1930名社区动脉粥样硬化风险研究参与者，他们在访视6（2016-17）时佩戴了无导线动态心电图监测仪（Zio XT Patch），并在访视6和访视4时测量了心脏生物标志物（中位数为19年前）。V6时参与者的平均年龄为79±5岁，41%为男性，22%为黑人。调整人口统计学、体重指数、吸烟、糖尿病、高血压、卒中、左心室质量、心脏药物、贴剂佩戴时间、访视4 NT-proBNP和hs-cTnT水平以及hs-cTnT的相对变化后，NT-proBNP的每个对数转换单位相对增加与非持续性室性心动过速的可能性较高相关（比值比1.29，95%置信区间（CI）1.12-1.48），每日房性心动过速发作次数较高（几何均值比（GMR）1.16，95% CI 1.10-1.21），每日异位负荷较高（室性早搏-GMR 1.42，95% CI 1.25-1.62;房性早搏-GMR 1.40，95% CI 1.25-1.57）。在完全调整的分析中，仅发现hs-cTnT的每个对数转换单位相对增加与较高的每日室性期前收缩负荷弱相关（GMR 1.31，95%CI 1.01-1.70）。总之，NT-proBNP的纵向变化与房性和室性心律失常负荷增加相关。
We evaluated the association of longitudinal changes in circulating levels of N-terminal pro B-type natriuretic peptide (NT-proBNP) and high sensitivity cardiac troponin T (hs-cTnT) with the burden of arrhythmias as captured by two-week ambulatory ECG monitoring. This study included 1930 Atherosclerosis Risk in Communities Study participants who wore a leadless, ambulatory ECG monitor (Zio XT Patch) at visit 6 (2016–17) and had cardiac biomarkers measured at visit 6 and visit 4 (median of 19 years earlier). The mean age of participants at V6 was 79±5 years, 41% were men, and 22% were black. Adjusting for demographics, body mass index, smoking, diabetes, hypertension, stroke, left ventricular mass, cardiac medications, patch wear time, visit 4 levels of NT-proBNP and hs-cTnT, and relative change in hs-cTnT, each log-transformed unit relative increase in NT-proBNP was associated with a higher likelihood of non-sustained ventricular tachycardia (odds ratio 1.29, 95% confidence interval (CI) 1.12–1.48), a higher number of daily atrial tachycardia episodes (geometric mean ratio (GMR) 1.16, 95% CI 1.10–1.21), and a higher daily ectopic burden (premature ventricular contractions —GMR 1.42, 95% CI 1.25–1.62; premature atrial contractions —GMR 1.40, 95% CI 1.25–1.57). In fully adjusted analyses, each log-transformed unit relative increase in hs-cTnT was only found to be weakly associated with a higher daily premature ventricular contraction burden (GMR 1.31, 95% CI 1.01–1.70). In conclusion, longitudinal change in NT-proBNP was associated with an increased atrial and ventricular arrhythmia burden.
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