静息心肺适能与心房颤动风险：特隆赫姆健康研究。
Estimated Cardiorespiratory Fitness and Risk of Atrial Fibrillation: The Nord-Trøndelag Health Study.
机构信息
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NORWAY.
Clinic of Cardiology, St. Olav's Hospital, Trondheim, NORWAY.
出版信息
Med Sci Sports Exerc. 2019 Dec;51(12):2491-2497. doi: 10.1249/MSS.0000000000002074.
PURPOSE
To investigate the association between estimated cardiorespiratory fitness (eCRF) and risk of atrial fibrillation (AF), and examine how long-term changes in eCRF affects the AF risk.
METHODS
This prospective cohort study includes data of 39,844 men and women from the HUNT2 (August 15, 1995 to June 18, 1997) and the HUNT3 study (October 3, 2006 to June 25, 2008). The follow-up period was from HUNT3 until AF diagnosis or November 30, 2015. The AF diagnoses were retrieved from hospital registers and validated by medical doctors. A nonexercise test based on age, waist circumference, resting heart rate and self-reported physical activity was used to estimate CRF. Cox regression was performed to assess the association between eCRF and AF.
RESULTS
The mean age was 50.6 ± 14.6 yr for men and 50.2 ± 15.2 yr for women. Mean follow-up time was 8.1 yr. One thousand fifty-seven cases of AF were documented. For men, the highest risk reduction of AF was 31% in the fourth quintile of eCRF when compared with the first quintile (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.53-0.89). For women, the highest risk reduction was 47% in the fifth quintile when compared with the first quintile (HR, 0.53; 95% CI, 0.38-0.74). One metabolic equivalent increase in eCRF over a 10-yr period was associated with 7% lower risk of AF (HR, 0.93; 95% CI, 0.86-1.00). Participants with improved eCRF had 44% lower AF risk compared with those with decreased eCRF (HR, 0.56; 95% CI, 0.36-0.87).
CONCLUSIONS
The eCRF was inversely associated with AF, and participants with improved eCRF over a 10-yr period had less risk of AF. These findings support the hypothesis that fitness may prevent AF.
目的
研究估计的心肺功能（eCRF）与心房颤动（AF）风险之间的关联，并探讨 eCRF 的长期变化如何影响 AF 风险。
方法
这项前瞻性队列研究纳入了来自 HUNT2（1995 年 8 月 15 日至 1997 年 6 月 18 日）和 HUNT3 研究（2006 年 10 月 3 日至 2008 年 6 月 25 日）的 39844 名男性和女性的数据。随访期从 HUNT3 开始，直至 AF 诊断或 2015 年 11 月 30 日。通过医院登记处检索 AF 诊断，并由医生进行验证。使用基于年龄、腰围、静息心率和自我报告体力活动的非运动测试来估计 CRF。使用 Cox 回归评估 eCRF 与 AF 之间的关联。
结果
男性的平均年龄为 50.6 ± 14.6 岁，女性的平均年龄为 50.2 ± 15.2 岁。平均随访时间为 8.1 年。共记录了 1057 例 AF 病例。对于男性，与第一五分位相比，第四五分位的 AF 风险降低幅度最大，为 31%（风险比[HR]，0.69；95%置信区间[CI]，0.53-0.89）。对于女性，与第一五分位相比，第五五分位的 AF 风险降低幅度最大，为 47%（HR，0.53；95% CI，0.38-0.74）。在 10 年内 eCRF 每增加一个代谢当量，AF 风险降低 7%（HR，0.93；95% CI，0.86-1.00）。与 eCRF 下降的参与者相比，eCRF 改善的参与者发生 AF 的风险降低 44%（HR，0.56；95% CI，0.36-0.87）。
结论
eCRF 与 AF 呈负相关，在 10 年内 eCRF 得到改善的参与者发生 AF 的风险较低。这些发现支持了这样一种假设，即体能可能预防 AF。
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