Atrial fibrillation in incident dialysis patients
Atrial fibrillation in incident dialysis patients
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DOI：
10.1038/ki.2009.185
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发表时间：
2009-08-01
影响因子：
19.6
通讯作者：
Lozano, Cristobal
中科院分区：
文献类型：
--
作者：
Vazquez, Eduardo;Sanchez-Perales, Carmen;Lozano, Cristobal
尽管心血管疾病对透析患者很重要，但透析患者心房颤动的频率尚未确定。我们分析了开始透析的患者 4 年期间心房颤动的患病率、透析过程中的发生率及其对缺血性卒中和死亡率的影响。注意到诱发心房颤动的因素，以及心律失常对死亡率和缺血性中风表现的影响。在所研究的 256 名患者中，有 31 名患者在透析开始时出现房颤。年龄增加、左心房增大和女性性别与透析开始时心房颤动的存在独立相关。在 225 名透析开始时处于窦性心律的患者中，28 名患者在平均随访 2 年期间出现房颤。瓣膜钙化、束支传导阻滞、既往缺血性中风、射血分数较低、脉压较高和血红蛋白浓度较低是心房颤动临床演变的预测因素。总体而言，房颤使死亡风险增加 1.72 倍，使缺血性中风风险增加 9.8 倍。因此，心房颤动似乎相当普遍，并且其存在与重大风险相关。肾脏国际 (2009) 76, 324-330; doi：10.1038/ki.2009.185； 2009 年 6 月 3 日在线发布
Despite the importance of cardiovascular disease in dialysis patients, the frequency of atrial fibrillation in incident dialysis patients has not been determined. We analyzed the prevalence of atrial fibrillation in patients starting dialysis over a 4-year period, its occurrence over the course of dialysis, and its influence on ischemic stroke and mortality. Factors predisposing to atrial fibrillation were noted, as was the influence of arrhythmia on mortality and presentation of ischemic stroke. Of the 256 patients studied, 31 had atrial fibrillation at the start of dialysis. Increased age, larger left atrium, and female gender were independently related to the presence of atrial fibrillation at dialysis inception. Of the 225 patients who were in sinus rhythm at the start of dialysis, 28 developed atrial fibrillation during a mean follow-up time of 2 years. The presence of valvular calcifications, bundle branch block, previous ischemic stroke, lower ejection fraction, higher pulse pressure, and lower hemoglobin concentration were predictors of the clinical evolution of atrial fibrillation. Overall, atrial fibrillation increased mortality risk 1.72-fold and ischemic stroke risk 9.8-fold. Therefore, it appears that atrial fibrillation is quite prevalent and its presence is associated with significant risk. Kidney International (2009) 76, 324-330; doi:10.1038/ki.2009.185; published online 3 June 2009