Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Department of Heart and Vessels, Service of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Clin Cardiol. 2020 Jun;43(6):614-621. doi: 10.1002/clc.23356. Epub 2020 Apr 24.
Prolonged PR interval (PRi) is associated with adverse outcomes. However, PRi determinants are poorly known. We aimed to identify the clinical determinants of the PRi duration in the general population.
Some clinical data are associated with prolonged PRi.
Cross-sectional study conducted between 2014 and 2017. Electrocardiogram-derived PRi duration was categorized into normal or prolonged (>200 ms). Determinants were identified using stepwise logistic regression, and results were expressed as multivariable-adjusted odds ratio (OR) (95% confidence interval). A further analysis was performed adjusting for antiarrhythmic drugs, P-wave contribution to PRi duration, electrolytes (kalemia, calcemia, and magnesemia), and history of cardiovascular disease.
Overall, 3655 participants with measurable PRi duration were included (55.6% females; mean age 62 ± 10 years), and 330 (9.0%) had prolonged PRi. Stepwise logistic regression identified male sex (OR 1.41 [1.02-1.97]); aging (65-74 years: OR 2.29 [1.61-3.24], and ≥ 75 years: OR 4.21 [2.81-6.31]); increased height (per 5 cm, OR 1.15 [1.06-1.25]); hypertension (OR 1.37 [1.06-1.77]); and hs troponin T (OR 1.67 [1.15-2.43]) as significantly and positively associated, and high resting heart rate (≥70 beats/min, OR 0.43 [0.29-0.62]) as negatively associated with prolonged PRi. After further adjustment, male sex, aging and increased height remained positively, and high resting heart rate negatively associated with prolonged PRi. Hypertension and hs troponin T were no longer associated.
In a sample of the Swiss middle-aged population, male sex, aging and increased height significantly increased the likelihood of a prolonged PRi duration, whereas a high resting heart rate decreased it.
PR 间期延长（PRi）与不良结局相关。然而，PRi 的决定因素尚不清楚。我们旨在确定一般人群中 PRi 持续时间的临床决定因素。
一些临床数据与 PRi 延长有关。
这是一项在 2014 年至 2017 年间进行的横断面研究。心电图衍生的 PRi 持续时间分为正常或延长（>200ms）。使用逐步逻辑回归确定决定因素，结果表示为多变量调整后的比值比（OR）（95%置信区间）。进一步分析调整了抗心律失常药物、P 波对 PRi 持续时间的贡献、电解质（血钾、血钙和血镁）以及心血管疾病史。
共有 3655 名可测量 PRi 持续时间的参与者（55.6%为女性；平均年龄 62±10 岁），其中 330 名（9.0%）存在 PRi 延长。逐步逻辑回归确定男性（OR 1.41[1.02-1.97]）；年龄（65-74 岁：OR 2.29[1.61-3.24]，≥75 岁：OR 4.21[2.81-6.31]）；身高增加（每 5cm，OR 1.15[1.06-1.25]）；高血压（OR 1.37[1.06-1.77]）；和高 hs 肌钙蛋白 T（OR 1.67[1.15-2.43]）与 PRi 延长显著正相关，而静息心率高（≥70 次/分钟，OR 0.43[0.29-0.62]）与 PRi 延长负相关。进一步调整后，男性、年龄和身高增加仍与 PRi 延长呈正相关，静息心率高与 PRi 延长呈负相关。高血压和高 hs 肌钙蛋白 T不再与 PRi 延长相关。
在瑞士中年人群样本中，男性、年龄和身高增加显著增加 PRi 持续时间延长的可能性，而静息心率高则降低了这种可能性。
