JACC:低心率或心率变异性与房颤风险之间的关系如何?

2017-01-19 fsy MedSci原创

心脏自主神经功能紊乱经常在阵发性房颤(AF)之前发生。影响自动输入至心肌的干预可能会预防房颤。然而,低心率或心率变异性(HRV),是心脏自主神经功能障碍的非侵入性措施,是否与房颤发生相关尚不清楚。该研究的目的是探讨HRV和AF风险之间的关系。这项研究包括了在ARIC(社区中的动脉粥样硬化风险)队列中的11,715名中年成人,研究人员从基线(1987至1989)进行了2分钟心电图记录获得心率和HRV

心脏自主神经功能紊乱经常在阵发性房颤(AF)之前发生。影响自动输入至心肌的干预可能会预防房颤。然而,低心率或心率变异性(HRV),是心脏自主神经功能障碍的非侵入性措施,是否与房颤发生相关尚不清楚。

该研究的目的是探讨HRV和AF风险之间的关系。

这项研究包括了在ARIC(社区中的动脉粥样硬化风险)队列中的11,715名中年成人,研究人员从基线(1987至1989)进行了2分钟心电图记录获得心率和HRV测量。这些措施包括正常至正常RR间期的SD,高频(HF)(0.15至0.40Hz),低频(0.04至0.15Hz)和低频/ HF的比值(表示有更大的交感神经)。通过2011年ARIC随访的心电图,出院诊断或死亡证明来确定AF病例。

在平均随访19.4年期间,1,580名或13.5%的参与者发生房颤。基线心率<60次/分钟与AF的风险增加相关。较低的总体HRV以及增加的交感神经/副交感神经比例均与较高的AF风险独立相关联;正常至正常RR间期的SD,每降低1 SD的风险比为1.14(95%置信区间:1.08至1.21),对于HF为1.12(95%置信区间:1.06至1.17),而对于低频/HF为1.08(95%置信区间:1.03〜1.14)。

由低静息短期HRV表示的心脏自主神经功能障碍与更高的AF发生率相关。低心率可能与更高的AF风险相关。需要进一步的研究来确定普通人群中恢复自主神经平衡的干预措施是否可能预防房颤。

出处:

Sunil K. Agarwal, Faye L. Norby, Eric A. Whitsel,et al.Cardiac Autonomic Dysfunction and Incidence of Atrial Fibrillation,JACC,2017.1.19


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    2017-01-26 hbwxf
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