Long-term outcomes in individuals with prolonged PR interval or first-degree atrioventricular block.
Long-term outcomes in individuals with prolonged PR interval or first-degree atrioventricular block.
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DOI：
10.1001/jama.2009.888
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发表时间：
2009-06-24
影响因子：
120.7
通讯作者：
Wang, Thomas J.
中科院分区：
文献类型：
--
作者：
Cheng, Susan;Keyes, Michelle J.;Larson, Martin G.;McCabe, Elizabeth L.;Newton-Cheh, Christopher;Levy, Daniel;Benjamin, Emelia J.;Vasan, Ramachandran S.;Wang, Thomas J.
心电图PR间期延长，当PR超过200毫秒时称为一级房室传导阻滞，在临床上经常遇到。目的：探讨非卧床个体PR延长的临床意义。马萨诸塞州弗雷明翰的未来社区队列。我们研究了7575名接受常规12导联心电图检查的人(平均年龄46岁，其中54%为女性)。研究队列从1968-1974年的基线检查到2007年进行前瞻性跟踪。我们使用多变量调整的COX比例风险模型来检验PR间期与心律失常事件的发生率和死亡的关系。发生心房颤动(房颤)、植入起搏器和全因死亡。在随访期间，481名参与者发生了房颤，124名患者植入了起搏器，1739人死亡。在基线检查中，124名受试者的PR>；为200毫秒。PR>；200毫秒与PR≤200毫秒相比，房颤每万人年发病率分别为140(95%可信区间，95-208)和36(95%可信区间，32-39)，起搏器植入分别为59(95%可信区间，40-87)和6(95%可信区间，5-7)，死亡发生率为333(95%可信区间，260-428)和129(95%可信区间，123-135)。相应的绝对风险每年增加1.04%(房颤)、0.53%(起搏器)和2.05%(死亡)。在多变量分析中，PR每增加20毫秒，调整后的危险比(HR)：房颤1.12(95%可信区间1.02-1.22；p=0.018)；起搏器植入1.22(95%可信区间1.14-1.30；p<；0.001)；死亡1.08(95%可信区间1.02-1.13；p=0.005)。1度房室传导阻滞患者房颤的调整风险是2倍(HR 2.06；95%CI，1.36-3.12；P<；0.001)，安置起搏器的调整风险是3倍(HR 2.89；95%CI，1.83-4.57；P<；0.001)，死亡风险是调整后的1.4倍(HR 1.44，95%C，I1.09-1.91；P=0.01)。PR延长与房颤、植入起搏器和死亡的风险增加相关。
Prolongation of the electrocardiographic PR interval, known as first-degree atrioventricular block when the PR exceeds 200 milliseconds, is frequently encountered in clinical practice. To determine the clinical significance of PR prolongation in ambulatory individuals. Prospective, community-based cohort in Framingham, MA. We studied 7,575 individuals (mean age 46 years, 54% women) who underwent routine 12-lead electrocardiography. The study cohort was followed prospectively from baseline examinations in 1968–1974 through 2007. We used multivariable-adjusted Cox proportional hazards models to examine the relations of PR interval with the incidence of arrhythmic events and death. Incident atrial fibrillation (AF), pacemaker implantation, and all-cause mortality. During follow up, 481 participants developed AF, 124 required pacemaker implantation, and 1,739 died. At the baseline examination, 124 individuals had PR >200 milliseconds. Incidence rates per 10,000 person-years for those with PR >200 milliseconds compared to those with PR ≤200 milliseconds were 140 (95% confidence interval [CI], 95–208) versus 36 (95% CI, 32–39) for AF, 59 (95% CI, 40–87) versus 6 (95% CI, 5–7) for pacemaker implantation, and 333 (95%, CI 260–428) versus 129 (95% CI, 123–135) for death. Corresponding absolute risk increases were 1.04% (AF), 0.53% (pacemaker), and 2.05% (death) per year. In multivariable analyses, each 20-millisecond increment in PR was associated with an adjusted hazards ratio (HR) of 1.12 (95% CI, 1.02–1.22; p=0.018) for AF, 1.22 (95% CI, 1.14–1.30; p<0.001) for pacemaker implantation, and 1.08 (95% CI, 1.02–1.13; p=0.005) for death. Individuals with first-degree atrioventricular block had a two-fold adjusted risk of AF (HR 2.06; 95% CI, 1.36–3.12; p<0.001), three-fold adjusted risk of pacemaker implantation (HR 2.89; 95% CI, 1.83–4.57; p<0.001), and 1.4-fold adjusted risk of death (HR 1.44, 95% C,I 1.09–1.91; p=0.01). PR prolongation is associated with increased risks of AF, pacemaker implantation, and death.
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DOI：
10.1111/j.1542-474x.2001.tb00092.x
发表时间：
2001-04-01
影响因子：
1.9
作者：
Dilaveris, PE;Färbom, P;Malik, M
通讯作者：
Malik, M
影响因子：
37.8
作者：
LEIER, CV;MEACHAM, JA;SCHAAL, SF
通讯作者：
SCHAAL, SF
影响因子：
120.7
作者：
BENJAMIN, EJ;LEVY, D;WOLF, PA
通讯作者：
WOLF, PA
影响因子：
1.3
作者：
KINOSHITA, S;KONISHI, G
通讯作者：
KONISHI, G
影响因子：
5
作者：
KANNEL, WB;FEINLEIB, M;CASTELLI, WP
通讯作者：
CASTELLI, WP