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年轻健康成年人室性早搏的危险因素。

Risk factors for premature ventricular contractions in young and healthy adults.

作者信息

von Rotz Mirco, Aeschbacher Stefanie, Bossard Matthias, Schoen Tobias, Blum Steffen, Schneider Susanna, Estis Joel, Todd John, Risch Martin, Risch Lorenz, Conen David

机构信息

Division of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland.

Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland.

出版信息

Heart. 2017 May;103(9):702-707. doi: 10.1136/heartjnl-2016-309632. Epub 2016 Oct 21.

Abstract

BACKGROUND

Premature ventricular contractions (PVCs) are associated with an increased risk of morbidity and mortality. Therefore, it was aimed to assess risk factors for the frequency of PVCs in young and healthy adults.

METHODS

Our population-based study included 2048 healthy adults from the general population aged 25-41 years. PVC frequency was determined by 24-hour Holter ECG. We performed multivariable regression analysis using stepwise backward selection to identify factors independently associated with PVC frequency.

RESULTS

Median age was 37 years, 953 (46.5%) were male. At least one PVC during the 24-hour monitoring period was observed in 69% of participants. Median number of detected PVCs was 2, the 95th percentile was 193. In multivariable regression analyses, we found 17 significant risk factors for PVC frequency. Low educational status (risk ratio (RR) 3.33; 95% CI 1.98 to 5.60), body height>median (1.58, 95% CI 1.11 to 2.24) and increasing levels of waist:hip ratio (2.15, 95% CI 1.77 to 2.61), N-terminal pro brain natriuretic peptide (1.52, 95% CI 1.30 to 1.76) and Sokolow-Lyon Index (1.38, 95% CI 1.15 to 1.66) (all p≤0.01) were associated with a higher PVC frequency. Physical activity (RR fourth vs first quartile 0.51, 95% CI 0.34 to 0.76) and increasing levels of haemoglobin (0.58, 95% CI 0.47 to 0.70) and glucagon-like peptide-1 (0.72, 95% CI 0.64 to 0.82) (all p<0.001) were related to a lower PVC frequency.

CONCLUSIONS

PVC occurrence is common even in healthy low-risk individuals, and its frequency is associated with several covariates mainly related to cardiovascular risk factors, markers of cardiac structure and function and socioeconomic status.

摘要

背景

室性早搏(PVCs)与发病和死亡风险增加相关。因此,本研究旨在评估年轻健康成年人PVCs发生频率的风险因素。

方法

我们基于人群的研究纳入了2048名年龄在25 - 41岁的普通人群中的健康成年人。通过24小时动态心电图确定PVCs频率。我们使用逐步向后选择法进行多变量回归分析,以确定与PVCs频率独立相关的因素。

结果

中位年龄为37岁,953名(46.5%)为男性。69%的参与者在24小时监测期内至少出现一次PVCs。检测到的PVCs中位数为2次,第95百分位数为193次。在多变量回归分析中,我们发现了17个与PVCs频率相关的显著风险因素。低教育水平(风险比(RR)3.33;95%置信区间1.98至5.60)、身高>中位数(1.58,95%置信区间1.11至2.24)以及腰臀比升高(2.15,95%置信区间1.77至2.61)、N末端脑钠肽前体(1.52,95%置信区间1.30至1.76)和索科洛夫 - 里昂指数(1.38,95%置信区间1.15至1.66)(所有p≤0.01)与较高的PVCs频率相关。体力活动(RR第四分位数与第一分位数相比为0.51,95%置信区间0.34至0.76)以及血红蛋白水平升高(0.58,95%置信区间0.47至0.70)和胰高血糖素样肽 - 1水平升高(0.72,95%置信区间0.64至0.82)(所有p<0.001)与较低的PVCs频率相关。

结论

即使在健康的低风险个体中,PVCs的发生也很常见,其频率与几个主要与心血管危险因素、心脏结构和功能标志物以及社会经济地位相关的协变量有关。

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