The association between hyperuricemia, left atrial size and new-onset atrial fibrillation
The association between hyperuricemia, left atrial size and new-onset atrial fibrillation
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DOI：
10.1016/j.ijcard.2013.06.067
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发表时间：
2013-10-09
影响因子：
3.5
通讯作者：
Chen, Shih-Ann
中科院分区：
文献类型：
--
作者：
Chao, Tze-Fan;Hung, Chung-Lieh;Chen, Shih-Ann
背景资料：虽然高尿酸血症与多种心血管疾病有关，但尿酸（UA）在左心房（LA）重构和新发心房颤动（AF）中的作用尚未完全探讨。本研究的目的是在大规模队列研究中探讨UA、LA直径与AF发生的关系。首先，我们在单中心数据库中研究了血清UA和LA直径之间的关系（n = 3043）。其次，我们研究并比较了台湾全国纵向队列中有和没有高尿酸血症的患者新发AF的风险（n = 122，524）。结果：血清UA水平升高与全身炎症增加和胰岛素抵抗相关。LA直径与血清UA呈显著相关（r = 0.341，p < 0.001）。校正临床、生化和超声心动图变量后，LA尺寸和UA水平之间的线性相关性仍然显著。在全国队列中，有2339例患者（研究人群的1.9%）在6.3 +/- 3.0年的随访期间发生AF。高尿酸血症患者的房颤发生率高于无高尿酸血症患者（2.1% vs 1.7%; p值< 0.001）。在多变量考克斯回归分析中，高尿酸血症是新发AF的重要危险因素，风险比为1.191（95%置信区间= 1.098-1.292，p值B 0.001）。结论：高尿酸血症与较大的LA大小相关，可能是AF发展的新危险因素。（C）2013 Elsevier爱尔兰Ltd.保留所有权利。
Background: Although hyperuricemia was associated with several cardiovascular diseases, the role of uric acid (UA) in left atrial (LA) remodeling and new-onset atrial fibrillation (AF) has not been fully explored. The goal of the present study is to investigate the relationship between UA, LA diameter and the development of AF in the large-scale cohort.Methods: The study consisted of 2 parts. First, we investigated the association between serum UA and LA diameter in a single-center database (n = 3043). Second, we studied and compared the risk of new onset AF among patients with and without hyperuricemia in the nationwide longitudinal cohort in Taiwan (n = 122,524).Results: Elevated serum level of UA was associated with an increased systemic inflammation, and insulin resistance. The LA diameter was significantly correlated with serum UA (r = 0.341, p value < 0.001). The linear correlation between LA dimension and UA level remained significant after the adjustment for clinical, biochemical and echocardiographic variables. In the nationwide cohort, there were 2339 patients (1.9% of the study population) developing AF during the follow-up of 6.3 +/- 3.0 years. The AF occurrence rate was higher in patients with hyperuricemia than those without it (2.1% versus 1.7%; p value < 0.001). Hyperuricemia was a significant risk factor of new-onset AF with a hazard ratio of 1.191 (95% confidence interval = 1.098-1.292, p value b 0.001) in the multivariate Cox regression analysis.Conclusions: Hyperuricemia was associated with a larger LA size and may be a novel risk factor for the development of AF. (C) 2013 Elsevier Ireland Ltd. All rights reserved.