Hypertension:房颤患者血压与脑损伤的关系

2021-01-05 MedSci原创 MedSci原创

在房颤患者中,BP与白质病变及其程度密切相关,但与大的非皮质或皮质梗塞无关。

房颤患者血压(BP)和高血压与不同类型脑损伤的相关性尚未明确。近日,血管权威杂志Hypertension上发表了一篇研究文章,研究人员从多中心房颤患者队列中获得了患者的BP值。

根据预定设定的组别对收缩压和舒张压进行分类,所有患者均接受了脑磁共振成像和神经认知检测。脑部病变分为大的非皮质或皮质梗塞、小的非皮质梗塞、微出血或白质病变。研究人员根据Fazekas量表对白质病变进行分级。

总体上,该横断面分析纳入了1738例房颤患者(平均年龄为73岁,男性占73%)。平均血压为135/79 mmHg,67%的参与者正在接受降压治疗。研究人员发现54%的患者白质病变Fazekas≥2,22%的患者伴有大的非皮质或皮质梗塞,21%的患者伴有小的非皮质梗塞,22%的患者伴有微出血。与收缩压<120 mmHg的患者相比,收缩压为120至140、140至160和≥160mmHg的患者Fazekas≥2的校正比值比(95%CI)分别为1.25(0.94–1.66)、1.41(1.03–1.93)和2.54(1.65–3.95)(线性趋势P<0.001)。收缩压和舒张压每升高5 mmHg,经对数转换的白质病变调整后的β系数(95%CI)分别为0.04(0.02–0.05),P<0.001和0.04(0.01–0.06),P = 0.004 。收缩压与较小的非皮质梗死相关(每增加5mmHg的比值比[95%CI]为1.05 [1.01-1.08],P=0.006),微出血与高血压相关,但较大的非皮质或皮质梗死与血压或高血压无关。经过多变量调整后,血压和高血压与神经认知功能无关。

由此可见,在房颤患者中,BP与白质病变及其程度密切相关,但与大的非皮质或皮质梗塞无关

原始出处:

Stefanie Aeschbacher.et al.Blood Pressure and Brain Lesions in Patients With Atrial Fibrillation.Hypertension.2021.https://doi.org/10.1161/HYPERTENSIONAHA.120.16025

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    2021-01-06 神盾医疗局局长Jack

    在房颤患者中,BP与白质病变及其程度密切相关,但与大的非皮质或皮质梗塞无关。

    0

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    2021-01-06 心介

    房颤,临床上碰到很多哦

    0

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肥胖与房颤发生风险增加有关,但体重指数与房颤风险之间的关系呈J型,并且这种关系因人种而异,因此,BMI较高的美籍华裔参与者的房颤风险增加更为明显,而黑人参与者的风险增加最小。

JAHA:老年人虚弱与房颤之间的关联

虚弱与心血管疾病之间存在双向关联,但并未发现虚弱与AF之间存在关联的证据。该研究的结果可能受到样本量的限制,应该在其他人群中进一步探索。

JAMA:地高辛或比索洛尔心率控制治疗对房颤患者生活质量的影响

对于永久性心房颤动并伴有心衰症状的患者,接受低剂量地高辛或比索洛尔以控制心率对改善患者生活质量无显著帮助

陆士娟:累积左心耳封堵术的中国数据与经验,开拓中国特色创新之路

左心耳封堵作为房颤综合治疗的重要补充,不仅理论科学、技术可行,而且远期效果确切。LAAC技术在中国虽起步较晚,但发展速度较快,在手术例数、优化患者选择、器械研发、操作技巧以及并发症的防治方面不断取得新

JAHA:9-癸烯酰肉碱与房颤有关

这项非靶向代谢组学分析发现了一种新的参与房颤发生的生物标记物9-癸烯酰肉碱,但这种乙酰肉碱可能与房颤没有因果关系。