Predictors of atrial ectopy and their relationship to atrial fibrillation risk
Predictors of atrial ectopy and their relationship to atrial fibrillation risk
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DOI：
10.1093/europace/euz008
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发表时间：
2019-06-01
期刊：
影响因子：
6.1
通讯作者：
Marcus, Gregory M.
中科院分区：
文献类型：
--
作者：
Kerola, Tuomas;Dewland, Thomas A.;Marcus, Gregory M.
目的 已知房性早搏 (PAC) 会触发和预测心房颤动 (AF)。我们试图确定 PAC 的决定因素以及 PAC 介导已确定的 AF 危险因素影响的程度。方法和结果 使用动态心电图研究对心血管健康研究（一个基于社区的 65 岁个体队列）的 1392 名参与者进行了基线 PAC 频率的预测因子检查。然后对参与者进行首次 AF 诊断的随访。确定了 PAC 的独立预测因素，并确定了 PAC 可能介导这些预测因素与 AF 之间关系的程度。每小时 PAC 频率中位数为 2.7（四分位数范围 0.8-12.1）。经过多变量调整后，年龄增加、身高增加、体重指数下降和心肌梗塞病史均与更多 PAC 相关。关于可修改的预测因素，使用 β 受体阻滞剂的参与者的 PAC 减少了 21% [95% 置信区间 (95% CI) 9-30%，P=0.001]，而至少进行中等强度运动的参与者与较低强度运动的参与者相比，PAC 减少了 10%（95% CI 1-18%，P=0.03）。 PAC 频率较高的解释为 34%（95% CI 22-57%，P
Aims Premature atrial contractions (PACs) are known to trigger and predict atrial fibrillation (AF). We sought to identify the determinants of PACs and the degree to which PACs mediate the effects of established risk factors for AF.Methods and results Predictors of baseline PAC frequency were examined using a Holter Study among 1392 participants in the Cardiovascular Health Study, a community-based cohort of individuals aged 65years. Participants were then followed for their first diagnosis of AF. Independent predictors of PACs were identified, and the extent to which PACs might mediate the relationship between those predictors and AF was determined. The median hourly frequency of PACs was 2.7 (interquartile range 0.8-12.1). After multivariable adjustment, increasing age, increasing height, decreasing body mass index, and a history of myocardial infarction were each associated with more PACs. Regarding modifiable predictors, participants using beta-blockers had 21% less [95% confidence interval (95% CI) 9-30%, P=0.001] and those performing at least moderate intensity exercise vs. lower intensity exercisers had 10% less (95% CI 1-18%, P=0.03) PACs. Higher PAC frequency explained 34% (95% CI 22-57%, P