Bandorski Dirk, Bogossian Harilaos, Ecke Anja, Wiedenroth Christoph, Gruenig Ekkehard, Benjamin Nicola, Arlt Matthias, Seeger Werner, Mayer Eckhard, Ghofrani Ardeschir, Hoeltgen Reinhard, Gall Henning
University of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany.
Cardiol J. 2016;23(4):465-72. doi: 10.5603/CJ.a2016.0044. Epub 2016 Jul 1.
Several studies have analyzed arrhythmias in patients with pulmonary hypertension (PH) and increased P-wave duration was identified as a risk factor for development of atrial fibrillation (AF).
We retrospectively analyzed the incidence of arrhythmias in patients with an initial diagnosis of PH during long-term follow-up and assessed the prognostic value of electrocardiography (ECG) data. Data from 167 patients were analyzed (Dana Point Classification: Group 1: 59 patients, Group 2: 28 patients, Group 3: 39 patients, Group 4: 41 patients). Clinical, 6-min-ute walk distance test, echocardiography and right heart catheterization data were collected, and baseline/follow-up ECGs were analyzed.
Baseline ECGs revealed sinus rhythm in 137 patients. Thirteen patients had newly onset AF during follow-up. In 30 patients, baseline ECG showed AF. Patients with baseline AF showed higher atrial diameters and higher right atrial pressure. Patients with P-wave du-ration > 0.11 s had shorter survival. Other ECG parameters (PQ-interval, QRS-width, QT-/ /QTc-interval) were not associated with survival. Mean survival times were 79.4 ± 5.4 months (sinus rhythm), 64.4 ± 12.9 months (baseline AF) and 58.8 ± 8.9 months (newly onset AF during follow-up) (p = 0.565).
Atrial fibrillation predict adverse prognosis in patients with PH and a longer P-wave (> 0.11 s) is associated with shorter survival time.
多项研究分析了肺动脉高压（PH）患者的心律失常情况，发现P波时限延长是心房颤动（AF）发生的危险因素。
我们回顾性分析了初诊为PH的患者在长期随访期间心律失常的发生率，并评估了心电图（ECG）数据的预后价值。分析了167例患者的数据（达纳点分类：1组：59例，2组：28例，3组：39例，4组：41例）。收集了临床、6分钟步行距离测试、超声心动图和右心导管检查数据，并分析了基线/随访心电图。
基线心电图显示137例患者为窦性心律。13例患者在随访期间新发房颤。30例患者基线心电图显示房颤。基线房颤患者的心房直径和右心房压力较高。P波时限>0.11 s的患者生存期较短。其他心电图参数（PQ间期、QRS宽度、QT/QTc间期）与生存期无关。平均生存时间分别为79.4±5.4个月（窦性心律）、64.4±12.9个月（基线房颤）和58.8±8.9个月（随访期间新发房颤）（p = 0.565）。
心房颤动预示着PH患者预后不良，较长的P波（>0.11 s）与较短的生存时间相关。
