Age-related changes in human left and right atrial conduction
Age-related changes in human left and right atrial conduction
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DOI：
10.1111/j.1540-8167.2005.00293.x
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发表时间：
2006-02-01
影响因子：
2.7
通讯作者：
Peters, N
中科院分区：
文献类型：
--
作者：
Kojodjojo, P;Kanagaratnam, P;Peters, N
简介：年龄增长是房颤（AF）的独立危险因素，房颤被认为是由异位触发引发并由致炎基质维持。目前尚不清楚是否基板的变化产生这种年龄相关的增加倾向于AF。我们解决了这一假设，即年龄的增长与双房电生理的变化，即使在患者没有房性心律失常的历史。方法和结果：患者左侧旁道和需要常规电生理研究被招募。对23例心脏结构正常、无房颤病史的患者（年龄17 ~ 75岁）进行了左、右心房电解剖标测。与以往的研究不同，三角法被用来量化波前传播速度（WPV）精确的传播方向。在三个不同的心房部位测量2个周期长度的不应性。右心房（r =-0.77，P < 0.0001）和左心房（r =-0.79，P < 0.001）WPV与年龄呈显著负相关。此外，左、右WPV高度相关（r = 0.66，P < 0.01），右心房的速度高6.4 +/- 2.2 cm/sec（P < 0.01）。不应性仅在鼻中隔处与年龄呈显著相关（r = 0.53，P < 0.01）。左房波长与年龄呈负相关（r =-0.56，P = 0.03）。P波时限与年龄（r = 0.42，P = 0.04）和左房大小（r = 0.44，P = 0.04）有关，但与心房WPV无关。结论：老年人心房WPV呈进行性下降，间隔不应期增加。这些与年龄相关的双心房电生理变化可能是房颤患病率与年龄相关性增加的重要因素。
Introduction: Advancing age is an independent risk factor for atrial fibrillation (AF), which is considered to be initiated by ectopic triggers and maintained by an arrhythmogenic substrate. It is not known whether substrate changes produce this age-related increase in propensity toward AF. We addressed the hypothesis that advancing age is associated with changes in biatrial electrophysiology even in patients with no history of atrial arrhythmias.Methods and Results: Patients with left-sided accessory pathways and requiring routine electrophysiological studies were recruited. Electroanatomic mapping was performed in the left and right atria of 23 patients (age ranging from 17 to 75 years) with structurally normal hearts and no history of AF during sinus rhythm and pacing. Unlike previous studies, a trigonometric method was used to quantify wavefront propagation velocities (WPV) precisely in the direction of propagation. Refractoriness was measured at 2 cycle lengths, at three different atrial sites. Both right (r =-0.77, P < 0.0001) and left (r =-0.79, P < 0.001) atrial WPV demonstrated strongly inverse correlation with age. Furthermore, left and right WPVs were highly correlated (r = 0.66, P < 0.01), with velocities being 6.4 +/- 2.2 cm/sec higher in the right atria (P < 0.01). Refractoriness was significantly correlated with increasing age only at the septum (r = 0.53, P < 0.01). Left atrial wavelength was inversely correlated with increasing age (r =-0.56, P = 0.03). P wave duration was associated with age (r = 0.42, P = 0.04) and left atrial size (r = 0.44, P = 0.04) but not atrial WPV.Conclusion: Aging human atria demonstrate progressive decline in WPV and increase in septal refractoriness. These age-related changes in biatrial electrophysiology are likely to be important factors in the age-related increase in AF prevalence.