Korantzopoulos Panagiotis, Kyrlas Konstantinos, Liu Tong, Li Guangping, Goudevenos John A
First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
J Cardiol. 2016 Jun;67(6):551-4. doi: 10.1016/j.jjcc.2015.07.013. Epub 2015 Aug 25.
Sick sinus syndrome (SSS) is associated with atrial fibrillation (AF). Red blood cell distribution width (RDW) is a marker of anisocytosis of erythrocytes and is related to inflammatory stress. Recently, RDW has been associated with AF. The aim of the present study was to evaluate the potential association of RDW with AF history in patients with SSS.
Consecutive patients with symptomatic SSS undergoing dual-chamber pacemaker implantation were screened. Baseline clinical, laboratory, echocardiographic, and electrocardiographic parameters were recorded. Conventional inflammatory indexes were also assessed. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis for parameters associated with AF were performed.
The final study population consisted of 101 patients (47 men); median age: 77 [73-82] years. The demographic and clinical characteristics were comparable between tachy-brady (AF history) patients (n=32) and patients with other forms of SSS (n=69). Left atrial diameter was increased in tachy-brady patients [44 (39-48)mm vs. 39 (36-44)mm; p=0.05]. Also, the RDW was greater in these patients [14.7 (13.6-15.4)% vs. 13.7 (13.4-14.3)%; p=0.02]. Multivariate analysis showed that RDW is independently associated with AF (OR: 1.58; 95% CI: 1.06-2.85; p=0.04). The ROC curve analysis showed that the area under the curve was 0.69 (p=0.028). A RDW cut-off point of 14 was related to AF with a sensitivity of 70% and a specificity of 69%.
RDW is associated with AF history in patients with SSS. The prognostic value of RDW in terms of future AF development and arrhythmia perpetuation in these patients should be further examined.
病态窦房结综合征（SSS）与心房颤动（AF）相关。红细胞分布宽度（RDW）是红细胞异质性的标志物，与炎症应激有关。最近，RDW与AF相关。本研究的目的是评估RDW与SSS患者AF病史之间的潜在关联。
对连续接受双腔起搏器植入的有症状SSS患者进行筛查。记录基线临床、实验室、超声心动图和心电图参数。还评估了传统炎症指标。对与AF相关的参数进行多因素逻辑回归分析和受试者工作特征（ROC）曲线分析。
最终研究人群包括101例患者（47例男性）；中位年龄：77[73 - 82]岁。心动过速 - 心动过缓（有AF病史）患者（n = 32）和其他形式SSS患者（n = 69）的人口统计学和临床特征具有可比性。心动过速 - 心动过缓患者的左心房直径增加[44（39 - 48）mm对39（36 - 44）mm；p = 0.05]。此外，这些患者的RDW更高[14.7（13.6 - 15.4）%对13.7（13.4 - 14.3）%；p = 0.02]。多因素分析显示RDW与AF独立相关（OR：1.58；95%CI：1.06 - 2.85；p = 0.04）。ROC曲线分析显示曲线下面积为0.69（p = 0.028）。RDW截断点为14与AF相关，敏感性为70%，特异性为69%。
RDW与SSS患者的AF病史相关。RDW在这些患者未来AF发展和心律失常持续方面的预后价值应进一步研究。
