Cardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Sci Rep. 2018 Apr 23;8(1):6366. doi: 10.1038/s41598-018-24875-1.
This study investigated the relationship between atrial fibrillation (AF) and left ventricular (LV) geometric patterns in a hospital-based population in Japan. We retrospectively analyzed 4444 patients who had undergone simultaneous scheduled transthoracic echocardiography (TTE) and electrocardiography during 2013. A total of 430 patients who had findings of previous myocardial infarctions (n = 419) and without the data on body surface area (n = 11) were excluded from the study. We calculated the LV mass index (LVMI) and relative wall (RWT) and categorized 4014 patients into four groups as follows: normal geometry (n = 3046); concentric remodeling (normal LVMI and high RWT, n = 437); concentric hypertrophy (high LVMI and high RWT, n = 149); and eccentric remodeling (high LVMI and normal RWT, n = 382). The mean left atrial volume indices (LAVI) were 22.5, 23.8, 33.3, and 37.0 mm/m in patients with normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy, respectively. The mean LV ejection fractions (LVEF) were 62.7, 62.6, 60.8, and 53.8%, respectively, whereas the prevalence of AF was 10.4%, 10.5%, 14.8%, and 16.8% in patients with normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy, respectively. In conclusion, the prevalence of AF was increasing according to LV geometric remodeling patterns in association with LA size and LVEF.
这项研究旨在探讨日本医院人群中心房颤动（AF）与左心室（LV）几何形态之间的关系。我们回顾性分析了 2013 年同时接受经胸超声心动图（TTE）和心电图检查的 4444 例患者。共有 430 例患者存在既往心肌梗死（n=419）和未记录体表面积（n=11）的资料，因此被排除在研究之外。我们计算了左心室质量指数（LVMI）和相对壁厚度（RWT），并将 4014 例患者分为以下 4 组：正常几何组（n=3046）；向心性重构组（正常 LVMI 和高 RWT，n=437）；向心性肥厚组（高 LVMI 和高 RWT，n=149）；和离心性重构组（高 LVMI 和正常 RWT，n=382）。正常几何组、向心性重构组、向心性肥厚组和离心性重构组的平均左心房容积指数（LAVI）分别为 22.5、23.8、33.3 和 37.0mm/m。平均左心室射血分数（LVEF）分别为 62.7%、62.6%、60.8%和 53.8%，而正常几何组、向心性重构组、向心性肥厚组和离心性重构组的 AF 患病率分别为 10.4%、10.5%、14.8%和 16.8%。总之，AF 的患病率随着 LV 几何重塑模式的变化而增加，与 LA 大小和 LVEF 相关。
