Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.
Division of Cardiology, Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
Heart. 2018 Mar;104(5):423-429. doi: 10.1136/heartjnl-2017-311825. Epub 2017 Sep 19.
Vital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.
The ARIC Study is a predominately biracial cohort of men and women, aged 45-64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.
Through 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).
Among participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.
活力耗竭(VE)是一种定义为缺乏能量、疲劳和易怒增加以及士气低落的状态,与心血管事件有关。我们试图在动脉粥样硬化风险社区(ARIC)研究中研究 VE 与心脏性猝死(SCD)之间的关系。
ARIC 研究是一项主要由男女组成的、以白人和黑人为主的队列研究,基线时年龄为 45-64 岁,于 1987 年从美国四个社区通过随机抽样开始。1990 年至 1992 年间,在 13923 名参与者中使用马斯特里赫特问卷测量 VE。Cox 比例风险模型用于检查 VE 评分三分位组之间院外 SCD 的风险。
截至 2012 年,通过医生记录审查,在 ARIC 中确定了 457 例 SCD 病例,定义为先前稳定的个体突然出现无脉搏状态,推测是由于室性心动过速引起的。在调整年龄、性别和种族/中心后,VE 最高三分位组的参与者发生 SCD 的风险增加(HR 1.48,95%CI 1.17 至 1.87),但这些发现在调整既定心血管疾病危险因素后不再显著(HR 0.94,95%CI 0.73 至 1.20)。
在 ARIC 研究参与者中,在调整心血管危险因素后,VE 与 SCD 的风险增加无关。