Premature atrial and ventricular contractions detected on wearable-format electrocardiograms and prediction of cardiovascular events.
Premature atrial and ventricular contractions detected on wearable-format electrocardiograms and prediction of cardiovascular events.
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DOI：
10.1093/ehjdh/ztad007
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发表时间：
2023-03
期刊：
影响因子：
--
通讯作者：
Lambiase, Pier D.
中科院分区：
文献类型：
--
作者：
Orini, Michele;van Duijvenboden, Stefan;Young, William J.;Ramirez, Julia;Jones, Aled R.;Tinker, Andrew;Munroe, Patricia B.;Lambiase, Pier D.
可穿戴设备正在将心电图（ECG）转变为无处不在的医疗测试。本研究评估了在无心血管疾病（CVD）的个体中，可穿戴格式ECG（15 s单导联）检测到的室性和房性早搏（PVC和PAC）与心血管结局之间的相关性。在来自N = 54 016名英国生物样本库参与者（中位年龄，四分位距，年龄58，50-63岁，54%女性）的15 s单导联ECG中识别出房性早搏和PVC。在11.5年（11.4-11.7年）的时间内，使用校正传统风险因素的考克斯回归模型确定与房颤（AF）、心力衰竭（HF）、心肌梗死（MI）、卒中、危及生命的室性心律失常（LTVA）和死亡率的相关性。在PVC（患病率2.2%）和HF（风险比，HR，95%置信区间= 2.09，1.58-2.78）之间以及PAC（患病率1.9%）和AF（HR = 2.52，2.11-3.01）之间发现了最强的相关性，早产时间较短进一步增加了风险。室性期前收缩和PAC也与LTVA相关（P < 0.05）。仅在未校正的模型中与MI、卒中和死亡率的相关性显著。在一项单独的英国生物样本库子研究样本中[UKB-2，N = 29，324，年龄64，58-60岁，54%女性，随访3.5（2.6-4.8）年]用于独立验证，调整风险因素后，PAC与AF相关（HR = 1.80，1.12-2.89）和PVC伴HF（HR = 2.32，1.28-4.22）。在没有CVD的中年个体中，在15 s单导联ECG中识别的过早收缩与AF和HF的风险增加密切相关。这些数据需要进一步研究，以评估可穿戴ECG在早期心血管风险分层中的作用。
Wearable devices are transforming the electrocardiogram (ECG) into a ubiquitous medical test. This study assesses the association between premature ventricular and atrial contractions (PVCs and PACs) detected on wearable-format ECGs (15 s single lead) and cardiovascular outcomes in individuals without cardiovascular disease (CVD). Premature atrial contractions and PVCs were identified in 15 s single-lead ECGs from N = 54 016 UK Biobank participants (median age, interquartile range, age 58, 50–63 years, 54% female). Cox regression models adjusted for traditional risk factors were used to determine associations with atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), stroke, life-threatening ventricular arrhythmias (LTVAs), and mortality over a period of 11.5 (11.4–11.7) years. The strongest associations were found between PVCs (prevalence 2.2%) and HF (hazard ratio, HR, 95% confidence interval = 2.09, 1.58–2.78) and between PACs (prevalence 1.9%) and AF (HR = 2.52, 2.11–3.01), with shorter prematurity further increasing risk. Premature ventricular contractions and PACs were also associated with LTVA (P < 0.05). Associations with MI, stroke, and mortality were significant only in unadjusted models. In a separate UK Biobank sub-study sample [UKB-2, N = 29,324, age 64, 58–60 years, 54% female, follow-up 3.5 (2.6–4.8) years] used for independent validation, after adjusting for risk factors, PACs were associated with AF (HR = 1.80, 1.12–2.89) and PVCs with HF (HR = 2.32, 1.28–4.22). In middle-aged individuals without CVD, premature contractions identified in 15 s single-lead ECGs are strongly associated with an increased risk of AF and HF. These data warrant further investigation to assess the role of wearable ECGs for early cardiovascular risk stratification.
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影响因子：
5
作者：
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
通讯作者：
Allen NE
影响因子：
18.2
作者：
Groenewegen A;Rutten FH;Mosterd A;Hoes AW
通讯作者：
Hoes AW
DOI：
10.1016/j.amjcard.2017.06.007
发表时间：
2017-09-01
期刊：
The American journal of cardiology
影响因子：
--
作者：
O'Neal WT;Kamel H;Judd SE;Safford MM;Vaccarino V;Howard VJ;Howard G;Soliman EZ
通讯作者：
Soliman EZ
影响因子：
9.3
作者：
Isakadze, Nino;Martin, Seth S.
通讯作者：
Martin, Seth S.
影响因子：
3.7
作者：
Orini, Michele;Tinker, Andrew;Lambiase, Pier D.
通讯作者：
Lambiase, Pier D.