Arai Riku, Suzuki Shinya, Semba Hiroaki, Arita Takuto, Yagi Naoharu, Otsuka Takayuki, Sagara Koichi, Sasaki Kenichi, Kano Hiroto, Matsuno Shunsuke, Kato Yuko, Uejima Tokuhisa, Oikawa Yuji, Kunihara Takashi, Yajima Junji, Yamashita Takeshi
Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.
Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.
J Cardiol. 2018 Jul;72(1):33-41. doi: 10.1016/j.jjcc.2018.01.001. Epub 2018 Feb 13.
The predictive role of E/e' on ischemic stroke (IS) and atrial fibrillation (AF) in Japanese patients without AF are unclear.
Shinken database includes all the new patients visiting the Cardiovascular Institute Hospital in Tokyo, Japan. E/e' has been routinely measured since 2007. Patients without AF for whom E/e' was measured at the initial visit between 2007 and 2014 (n=11 477, mean age 57.2 years old, men 59.5%) were divided into E/e' tertiles (<8.04, 8.04-11.00, >11.00). During the mean follow-up period of 1.8 years, 58 IS and 140 new appearances of AF were observed. High E/e' tertile was associated with more prevalence of atherothrombotic risks. The cumulative incidence of IS events and new appearance of AF at 6 years in low, middle, and high E/e' tertiles were 0.5%, 1.4%, and 3.0%/year (log-rank test, p<0.001), and 2.5%, 2.9%, and 4.2%/year (log-rank test, p=0.007), respectively. In multivariate analysis, high E/e' tertile was independently associated with IS (HR, 2.857, 95%CI 1.257-6.495, p=0.012). Although high E/e' tertile was independently associated with new appearance of AF when adjusted for coexistence of atherothrombotic risk factors (HR, 1.694, 95%CI, 1.097-2.616, p=0.017), the association was attenuated after adjustment for left atrial dimension.
E/e' was significantly associated with incidence of IS and new appearance of AF in non-AF patients.
在无房颤的日本患者中，E/e' 对缺血性卒中（IS）和房颤（AF）的预测作用尚不清楚。
Shinken 数据库包含了所有前往日本东京心血管研究所医院就诊的新患者。自 2007 年起常规测量 E/e'。将 2007 年至 2014 年初次就诊时测量了 E/e' 的无房颤患者（n = 11477，平均年龄 57.2 岁，男性占 59.5%）分为 E/e' 三分位数组（<8.04、8.04 - 11.00、>11.00）。在平均 1.8 年的随访期内，观察到 58 例 IS 事件和 140 例新发房颤。高 E/e' 三分位数组与动脉粥样硬化血栓形成风险的患病率更高相关。低、中、高 E/e' 三分位数组在 6 年时 IS 事件和新发房颤的累积发生率分别为 0.5%、1.4%和 3.0%/年（对数秩检验，p<0.001），以及 2.5%、2.9%和 4.2%/年（对数秩检验，p = 0.007）。在多变量分析中，高 E/e' 三分位数组与 IS 独立相关（HR，2.857，95%CI 1.257 - 6.495，p = 0.012）。尽管在调整动脉粥样硬化血栓形成风险因素共存后，高 E/e' 三分位数组与新发房颤独立相关（HR，1.694，95%CI，1.097 - 2.616，p = 0.017），但在调整左心房维度后，这种关联减弱。
在非房颤患者中，E/e' 与 IS 的发生率和新发房颤显著相关。
