Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Int J Cardiol. 2013 Apr 5;164(2):201-4. doi: 10.1016/j.ijcard.2011.06.126. Epub 2011 Jul 22.
Currently, precise mechanisms of atrial fibrillation (AF) are uncertain but proved to be associated with inflammation. There has been no specific study to evaluate the risk of AF after diagnosis of herpes simplex virus (HSV) infection.
To investigate the relationship between HSV infection and the occurrence of AF, we used a nation-wide population-based dataset from Taiwan. A total of 15,180 patients with diagnosis of HSV infection were included in the study group from a 1,000,000 sampling cohort dataset between January 2000 and December 2003. Another 73,197 age-, gender-, and comorbidity-matched subjects without HSV infection were included in the control group. The log-rank test was performed to analyze the differences in accumulated AF-free survival rates between these 2 groups. Cox proportional hazard regressions were performed to evaluate the independent factor in determining the longitudinal hazard of AF.
During a 3-year follow-up period, 240 patients from the study group (1.6%) and 801 patients from the comparison group (1.1%) had newly developed AF. The log-rank test showed that patients with HSV had significantly higher incidence of AF development than those without HSV (p<0.001). After Cox model adjustment for risk factors and comorbidities, HSV infection was independently associated with increased risk of AF development (hazard ratios [HR], 1.39; 95% confidence interval [CI], 1.2-1.60; p<0.0001).
Our study concludes that HSV infection may be independently associated with an increased risk of future AF development.
目前,心房颤动(AF)的确切机制尚不清楚,但已证实与炎症有关。尚未有专门研究评估单纯疱疹病毒(HSV)感染后发生 AF 的风险。
为了研究 HSV 感染与 AF 发生之间的关系,我们使用了来自台湾的一项全国性基于人群的数据集。在 2000 年 1 月至 2003 年 12 月期间,从一个 100 万抽样队列数据集中纳入了共 15180 例诊断为 HSV 感染的患者作为研究组。另外纳入了 73197 例年龄、性别和合并症相匹配且无 HSV 感染的患者作为对照组。采用对数秩检验分析两组间无 AF 生存累积率的差异。采用 Cox 比例风险回归分析评估确定 AF 纵向风险的独立因素。
在 3 年的随访期间,研究组中有 240 例患者(1.6%)和对照组中有 801 例患者(1.1%)新发 AF。对数秩检验显示,HSV 感染患者的 AF 发生率显著高于无 HSV 感染患者(p<0.001)。在调整了危险因素和合并症后,HSV 感染与 AF 发展风险增加独立相关(风险比 [HR],1.39;95%置信区间 [CI],1.2-1.60;p<0.0001)。
本研究表明,HSV 感染可能与未来 AF 发展风险增加独立相关。