Mattioli Anna Vittoria, Bonatti Silvia, Zennaro Mauro, Melotti Roberto, Mattioli Giorgio
Department of Biomedical Science, Italy.
J Cardiovasc Med (Hagerstown). 2008 Aug;9(8):794-8. doi: 10.2459/JCM.0b013e3282f64554.
The study evaluated the relationships between acute stress, lifestyle and coffee consumption, and acute lone atrial fibrillation (AF).
The study group included 400 patients with mean age of 54 +/- 11 years, 205 of whom were men. They all presented with a first episode of AF. Patients underwent a series of cognitive tests to evaluate acute psychological stress (mean life acute stress score). Lifestyle and nutritional parameters (diet, alcohol and espresso coffee consumption, smoking and obesity) were investigated. An age-matched and sex-matched control group was selected and compared.
Recent stress, high intake of coffee, and obesity were associated with greater risk of AF. Acute stress induces an increase in coffee consumption and changes in lifestyle. The increase in coffee consumption was more marked in nonhabitual drinkers, leading to a higher risk of developing AF [odds ratio (OR) 4.1; 95% confidence interval (CI): 1.98-4.56; P < 0.001]. Spontaneous conversion of AF to sinus rhythm was observed in 191 patients (47%). Patients who experienced AF after an acute stress showed the highest probability of spontaneous conversion. High espresso coffee consumption (OR 0.86; 95% CI: 0.49-1.21; P < 0.01) and obesity (OR 0.88; 95% CI: 0.84-1.20; P < 0.01) were associated with a significantly greater risk of persistent AF.
Acute stress induced changes in lifestyle, including an increase in coffee consumption, leading to a higher risk of AF. Patients who developed AF after an acute stress showed the highest probability of spontaneous conversion. High espresso coffee consumption and obesity were associated with an increased risk of persistent AF.
本研究评估急性应激、生活方式与咖啡摄入量和急性孤立性心房颤动（房颤）之间的关系。
研究组包括400例平均年龄为54±11岁的患者，其中205例为男性。他们均表现为首次发作的房颤。患者接受了一系列认知测试以评估急性心理应激（平均生活急性应激评分）。对生活方式和营养参数（饮食、酒精和浓缩咖啡摄入量、吸烟和肥胖情况）进行了调查。选取了年龄和性别匹配的对照组进行比较。
近期应激、高咖啡摄入量和肥胖与房颤风险增加相关。急性应激会导致咖啡摄入量增加和生活方式改变。非习惯性饮用者咖啡摄入量的增加更为明显，导致发生房颤的风险更高[比值比（OR）4.1；95%置信区间（CI）：1.98 - 4.56；P < 0.001]。191例患者（47%）观察到房颤自发转为窦性心律。急性应激后发生房颤的患者自发转换的概率最高。高浓缩咖啡摄入量（OR 0.86；95% CI：0.49 - 1.21；P < 0.01）和肥胖（OR 0.88；95% CI：0.84 - 1.20；P < 0.01）与持续性房颤的风险显著增加相关。
急性应激导致生活方式改变，包括咖啡摄入量增加，从而增加房颤风险。急性应激后发生房颤的患者自发转换的概率最高。高浓缩咖啡摄入量和肥胖与持续性房颤风险增加相关。
