Hennersdorf M G, Hafke G J, Steiner S, Dierkes S, Jansen A, Perings C, Strauer B E
Medizinische Klinik und Poliklinik B Klinik für Kardiologie, Pneumologie und Angiologie Heinrich-Heine-Universität Moorenstr. 5 40225 Düsseldorf, Germany.
Z Kardiol. 2003 May;92(5):370-6. doi: 10.1007/s00392-003-0924-5.
Atrial fibrillation represents an important arrhythmia, in particular in patients with arterial hypertension. Hitherto, the connection between paroxysmal atrial fibrillation, left atrial size and left ventricular muscle mass has not been investigated sufficiently. In the present study, determinants of paroxysmal atrial fibrillation in patients with arterial hypertension were evaluated.
104 consecutive patients were enrolled into this study. All of them suffered from arterial hypertension for more than one year. Persistent or permanent atrial fibrillation was not documented. In all of these patients, clinical, echocardiographic and rhythmologic variables were evaluated.
In 10.3% of the patients, paroxysmal atrial fibrillation was found. These patients showed a significantly larger left atrium (43.3 +/- 6.7 vs 37.5 +/- 4.9 mm, p < 0.001), a significantly higher muscle mass of the left ventricle (152.38 +/- 43.57 vs 134.41 +/- 27.19 g/m2, p < 0.01) and significantly more frequent a mild mitral regurgitation (38.1 vs 28.6%, p < 0.01). The multivariate regression analysis revealed as independent factors for paroxysmal atrial fibrillation the size of the left atrium and the presence of mild mitral regurgitation. Independent factors for an enlarged left atrium were mitral insufficiency and left ventricular muscle mass.
This study shows that paroxysmal atrial fibrillation in aterial hypertension is based on the left atrial size, and left atrial size on left ventricular muscle mass. Therefore, these results should lead to a causal therapy for treatment of paroxysmal atrial fibrillation in these patients.
心房颤动是一种重要的心律失常，在动脉高血压患者中尤为常见。迄今为止，阵发性心房颤动、左心房大小与左心室肌肉质量之间的关系尚未得到充分研究。在本研究中，对动脉高血压患者阵发性心房颤动的决定因素进行了评估。
104例连续患者纳入本研究。他们均患有动脉高血压超过一年。未记录到持续性或永久性心房颤动。对所有这些患者进行了临床、超声心动图和节律学变量评估。
10.3%的患者发现阵发性心房颤动。这些患者的左心房明显更大（43.3±6.7对37.5±4.9mm，p<0.001），左心室肌肉质量明显更高（152.38±43.57对134.41±27.19g/m2，p<0.01），轻度二尖瓣反流明显更频繁（38.1对28.6%，p<0.01）。多因素回归分析显示，阵发性心房颤动的独立因素是左心房大小和轻度二尖瓣反流的存在。左心房扩大的独立因素是二尖瓣关闭不全和左心室肌肉质量。
本研究表明，动脉高血压患者的阵发性心房颤动基于左心房大小，而左心房大小基于左心室肌肉质量。因此，这些结果应为这些患者阵发性心房颤动的治疗带来因果性治疗方法。
