Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up
Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up
复制标题
DOI：
10.1093/eurheartj/ehi483
复制
发表时间：
2005-12-01
影响因子：
39.3
通讯作者：
Seward, JB
中科院分区：
文献类型：
--
作者：
Osranek, M;Bursi, F;Seward, JB
目的-本研究的目的是确定长期的结果和预测不良事件的患者最初诊断为孤立性心房颤动（AF）。方法和结果这一人口为基础的历史队列研究包括46名居民的奥姆斯特德县，明尼苏达州，美国，记录良好，临床定义的孤立性AF和一个完整的二维超声心动图检查。以盲法分析原始超声心动图录像带记录的左心房容积（LAV）和左心室射血分数。在1296人-年的随访中，AF的中位持续时间为27年（第一四分位数=24，第三四分位数=33）。23例（50%）患者发生事件。脑梗死7例，心肌梗死11例，充血性心力衰竭16例。在多变量分析中，LAV指数>= 32 mL/m2的患者的无事件生存率显著更差（校正HR，4.46; 95% CI，1.56-12.74; P=0.005）。所有脑梗死均发生在LAV > 32 mL/m2的患者。结论根据LAV诊断，良性孤立性房颤患者的病程存在差异。那些最初诊断为孤立性房颤和正常大小心房的患者在整个长期随访期间具有良性临床病程。在诊断时或随后随访期间LAV增加的患者发生不良事件。
Aims The objectives of this study were to determine the long-term outcome and the predictors of adverse events in patients originally diagnosed with lone atrial fibrillation (AF).Methods and results This population-based historical cohort study comprised 46 residents of Olmsted County, MN, USA, with well-documented, clinically defined lone AF and a complete two-dimensional echocardiographic examination. The original echocardiographic videotape recordings were analysed in a blinded fashion for left atrial volume (LAV) and left ventricular ejection fraction. With 1296 person-years of follow-up, the median duration of AF was 27 (first quartile=24, third quartile=33) years. Twenty-three (50%) patients developed events. Cerebral infarction occurred in seven patients, myocardial infarction in 11, and congestive heart failure in 16. In a multivariable analysis, patients with indexed LAV >= 32 mL/m(2) had a significantly worse event-free survival (adjusted HR, 4.46; 95% CI, 1.56-12.74; P=0.005). All cerebral infarctions occurred in patients with an indexed LAV > 32 mL/m(2).Conclusion Patients originally diagnosed with benign lone AF follow divergent courses based on LAV. Those originally diagnosed with lone AF and normal sized atria had a benign clinical course throughout the long-term follow-up. Patients with increased LAV at diagnosis or later during the follow-up experienced adverse events.