Husby Michael P, Soliman Elsayed Z, Goldberger Jeffrey J, Liu Kiang, Lloyd-Jones Don, Durazo-Arvizu Ramon, Kramer Holly
Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA.
Department of Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA.
Cardiol Res Pract. 2015;2015:193698. doi: 10.1155/2015/193698. Epub 2015 Oct 19.
Introduction. Few studies have examined the association between the PR interval (PRi) and subclinical cardiovascular disease measures. Methods and Results. The Multiethnic Study of Atherosclerosis (MESA) is a population-based study of 6814 men and women aged 45-84 years without clinical cardiovascular disease and 4962 had complete baseline data on cardiac magnetic resonance imaging measures of LV dimension and ejection fraction and surface electrocardiogram. Linear regression models were constructed to determine the adjusted association between the PRi and measures of LV stroke volume, LV mass, LV end-systolic and end-diastolic volumes, and ejection fraction. Overall, mean age was 61.5 years, and 47.6% were male and race/ethnicity was white in 39.1%, Chinese in 13.1%, African-American in 25.7%, and Hispanic in 22.2%. The PRi ranged from 88 to 308 ms with a median value of 162 ms. As a continuous variable, every standard deviation unit (25 ms) increment in PRi was associated with a 2.00 mL (95% CI 1.52, 2.48) higher stroke volume, a 3.08 g (95% CI 2.30, 3.86) higher LV mass, a 1.36 g/m(2) (95% CI 0.96, 1.76) higher LV mass index, and 1.31 mL (95% CI 0.88, 1.73) higher end-systolic and 3.31 mL (95% CI 2.58, 4.03) higher end-diastolic volumes after adjustment for all covariates. No significant association was noted between the PRi and LV ejection fraction. Conclusions. A prolonged PRi is associated with LV measures and may in part explain the link between a prolonged PRi and cardiovascular outcomes.
引言。很少有研究探讨PR间期（PRi）与亚临床心血管疾病指标之间的关联。方法与结果。动脉粥样硬化多民族研究（MESA）是一项基于人群的研究，纳入了6814名年龄在45 - 84岁且无临床心血管疾病的男性和女性，其中4962人拥有关于左心室尺寸、射血分数的心脏磁共振成像测量数据以及体表心电图的完整基线数据。构建线性回归模型以确定PRi与左心室每搏输出量、左心室质量、左心室收缩末期和舒张末期容积以及射血分数测量值之间的校正关联。总体而言，平均年龄为61.5岁，47.6%为男性，种族/族裔分布为白人占39.1%、华裔占13.1%、非裔美国人占25.7%、西班牙裔占22.2%。PRi范围为88至308毫秒，中位数为162毫秒。作为连续变量，PRi每增加一个标准差单位（25毫秒），在对所有协变量进行校正后，与每搏输出量增加2.00毫升（95%置信区间1.52, 2.48）、左心室质量增加3.08克（95%置信区间2.30, 3.86）、左心室质量指数增加1.36克/平方米（95%置信区间0.96, 1.76）、收缩末期容积增加1.31毫升（95%置信区间0.88, 1.73）以及舒张末期容积增加3.31毫升（95%置信区间2.58, 4.03）相关。未发现PRi与左心室射血分数之间存在显著关联。结论。PRi延长与左心室测量指标相关，这可能部分解释了PRi延长与心血管结局之间的联系。
