Calvo Naiara, Ramos Pablo, Montserrat Silvia, Guasch Eduard, Coll-Vinent Blanca, Domenech Mònica, Bisbal Felipe, Hevia Sara, Vidorreta Silvia, Borras Roger, Falces Carles, Embid Cristina, Montserrat Josep Maria, Berruezo Antonio, Coca Antonio, Sitges Marta, Brugada Josep, Mont Lluís
Unitat de Fibril.lació Auricular, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Catalonia, Spain.
Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Catalonia, Spain Unitat d'Hipertensió i Risc Vascular, Hospital Clínic, Catalonia, Spain.
Europace. 2016 Jan;18(1):57-63. doi: 10.1093/europace/euv216. Epub 2015 Sep 1.
The role of high-intensity exercise and other emerging risk factors in lone atrial fibrillation (Ln-AF) epidemiology is still under debate. The aim of this study was to analyse the contribution of each of the emerging risk factors and the impact of physical activity dose in patients with Ln-AF.
Patients with Ln-AF and age- and sex-matched healthy controls were included in a 2:1 prospective case-control study. We obtained clinical and anthropometric data transthoracic echocardiography, lifetime physical activity questionnaire, 24-h ambulatory blood pressure monitoring, Berlin questionnaire score, and, in patients at high risk for obstructive sleep apnoea (OSA) syndrome, a polysomnography. A total of 115 cases and 57 controls were enrolled. Conditional logistic regression analysis associated height [odds ratio (OR) 1.06 [1.01-1.11]], waist circumference (OR 1.06 [1.02-1.11]), OSA (OR 5.04 [1.44-17.45]), and 2000 or more hours of cumulative high-intensity endurance training to a higher AF risk. Our data indicated a U-shaped association between the extent of high-intensity training and AF risk. The risk of AF increased with an accumulated lifetime endurance sport activity ≥ 2,000 h compared with sedentary individuals (OR 3.88 [1.55-9.73]). Nevertheless, a history of <2000 h of high-intensity training protected against AF when compared with sedentary individuals (OR 0.38 [0.12-0.98]).
A history of ≥ 2,000 h of vigorous endurance training, tall stature, abdominal obesity, and OSA are frequently encountered as risk factors in patients with Ln-AF. Fewer than 2000 total hours of high-intensity endurance training associates with reduced Ln-AF risk.
高强度运动及其他新出现的危险因素在孤立性心房颤动（Ln-AF）流行病学中的作用仍存在争议。本研究旨在分析各新出现危险因素的作用以及体力活动剂量对Ln-AF患者的影响。
一项前瞻性病例对照研究纳入了Ln-AF患者以及年龄和性别匹配的健康对照，病例与对照的比例为2:1。我们获取了临床和人体测量数据、经胸超声心动图、终生体力活动问卷、24小时动态血压监测、柏林问卷评分，对于阻塞性睡眠呼吸暂停（OSA）综合征高危患者，还进行了多导睡眠图检查。共纳入115例病例和57例对照。条件逻辑回归分析显示，身高[比值比（OR）1.06[1.01 - 1.11]]、腰围（OR 1.06[1.02 - 1.11]）、OSA（OR 5.04[1.44 - 17.45]）以及2000小时或更长时间的累积高强度耐力训练与更高的房颤风险相关。我们的数据表明高强度训练程度与房颤风险之间呈U形关联。与久坐不动的个体相比，终生累积耐力运动活动≥2000小时的个体房颤风险增加（OR 3.88[1.55 - 9.73]）。然而，与久坐不动的个体相比，高强度训练时间<2000小时的个体患房颤的风险较低（OR 0.38[0.12 - 0.98]）。
在Ln-AF患者中，经常会遇到≥2000小时的剧烈耐力训练史、高身材、腹部肥胖和OSA等危险因素。高强度耐力训练总时长少于2000小时与降低Ln-AF风险相关。
