Alcohol Consumption, Left Atrial Diameter, and Atrial Fibrillation.
Alcohol Consumption, Left Atrial Diameter, and Atrial Fibrillation.
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饮酒，剩余心房直径和心房颤动。
DOI：
10.1161/jaha.116.004060
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发表时间：
2016-09-14
影响因子：
5.4
通讯作者：
Marcus GM
中科院分区：
文献类型：
--
作者：
McManus DD;Yin X;Gladstone R;Vittinghoff E;Vasan RS;Larson MG;Benjamin EJ;Marcus GM
在一些流行病学研究中，饮酒与房颤（AF）有关，但其潜在机制仍不清楚。我们试图检验这一假设，即房性肌病，表现为超声心动图左心房扩大，解释了慢性饮酒和AF之间的关联。我们评估了5220名后代和原始心脏病研究参与者（平均年龄56.3岁，54%的女性）超声心动图左心房大小测量的累积饮酒量和事件AF的风险之间的关系。AF的发生率为8.4/1000人-年，在中位随访期6.0年（第25 - 75个月4.0-8.7年）内发生了1088例AF事件。在对潜在混杂因素进行多变量校正后，每天每增加10 g酒精（每天不到1杯）与左心房尺寸增大0.16 mm（95% CI，0.10-0.21 mm）相关。同样在多变量校正分析中，每天饮酒每10 g与新发AF风险增加5%相关（风险比，1.05; 95% CI，1.01-1.09）。估计24%（95%CI，8-75）的酒精和房颤风险之间的关联是由左心房扩大解释的。我们对一个大型的、基于社区的样本进行的研究发现，饮酒是左心房扩大和随后发生房颤的预测因子。左心房扩大可能是沿着将长期饮酒与房颤联系起来的因果通路的中间表型。
Alcohol consumption has been associated with atrial fibrillation (AF) in several epidemiologic studies, but the underlying mechanisms remain unknown. We sought to test the hypothesis that an atrial myopathy, manifested by echocardiographic left atrial enlargement, explains the association between chronic alcohol use and AF. We evaluated the relationship between cumulative alcohol consumption and risk of incident AF in 5220 Offspring and Original Framingham Heart Study participants (mean age 56.3 years, 54% women) with echocardiographic left atrial size measurements. The incidence of AF was 8.4 per 1000 person‐years, with 1088 incident AF cases occurring over a median 6.0 years (25th–75th percentiles 4.0–8.7 years) of follow‐up. After multivariable adjustment for potential confounders, every additional 10 g of alcohol per day (just under 1 drink per day) was associated with a 0.16 mm (95% CI, 0.10–0.21 mm) larger left atrial dimension. Also in multivariable adjusted analysis, every 10 g per day of alcohol consumed was associated with a 5% higher risk of developing new‐onset AF (hazard ratio, 1.05; 95% CI, 1.01–1.09). An estimated 24% (95% CI, 8–75) of the association between alcohol and AF risk was explained by left atrial enlargement. Our study of a large, community‐based sample identified alcohol consumption as a predictor of left atrial enlargement and subsequent incident AF. Left atrial enlargement may be an intermediate phenotype along the causal pathway linking long‐term alcohol consumption to AF.