循环电解质与心房颤动和室上性异位搏动的患病率：动脉粥样硬化风险社区（ARIC）研究。
Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: The Atherosclerosis Risk in Communities (ARIC) study.
机构信息
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
出版信息
Nutr Metab Cardiovasc Dis. 2020 Jun 25;30(7):1121-1129. doi: 10.1016/j.numecd.2020.03.010. Epub 2020 Mar 27.
BACKGROUND AND AIMS
Evaluating associations of circulating electrolytes with atrial fibrillation (AF) and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis.
METHODS AND RESULTS
We conducted a cross-sectional analysis of 6398 participants of the Atherosclerosis Risk in Communities (ARIC) study, ages 71-90, with data on serum electrolytes (magnesium, calcium, potassium, phosphorus, chloride, sodium). Prevalence of AF was determined from electrocardiograms and history of AF hospitalizations. A subset of 317 participants also underwent electrocardiographic recordings for up to 14 days using the Zio® patch. Burden of other supraventricular arrhythmias [premature atrial contractions (PACs), supraventricular tachycardia] was determined with the Zio® patch. We used logistic and linear regression adjusting for potential confounders to determine associations of electrolytes with arrhythmia prevalence and burden. Among 6394 eligible participants, 614 (10%) had AF. Participants in the top quintiles of magnesium [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.62, 1.08], potassium (OR 0.82, 95%CI 0.68, 1.00), and phosphorus (OR 0.73, 95%CI 0.59, 0.89) had lower AF prevalence compared to those in the bottom quintiles. No clear association was found for circulating chloride, calcium or sodium. Higher concentrations of circulating calcium were associated with lower prevalence of PACs in the 12-lead electrocardiogram, while higher concentrations of potassium, chloride and sodium were associated with higher PAC prevalence. Circulating electrolytes were not significantly associated with burden of PACs or supraventricular tachycardia among 317 participants with extended electrocardiographic monitoring.
CONCLUSION
Concentrations of circulating electrolytes present complex associations with selected supraventricular arrhythmias. Future studies should evaluate underlying mechanisms.
背景与目的
评估循环电解质与心房颤动（AF）和室上性心律失常负担的关联，可以深入了解心律失常的发病机制。
方法和结果
我们对动脉粥样硬化风险社区（ARIC）研究的 6398 名年龄在 71-90 岁的参与者进行了横断面分析，这些参与者的数据包括血清电解质（镁、钙、钾、磷、氯、钠）。通过心电图和 AF 住院史确定 AF 的患病率。其中 317 名参与者的亚组还使用 Zio®贴片进行了长达 14 天的心电图记录。使用 Zio®贴片确定其他室上性心律失常（房性早搏（PACs）、室上性心动过速）的负担。我们使用逻辑回归和线性回归调整潜在混杂因素，以确定电解质与心律失常患病率和负担的关联。在 6394 名合格参与者中，有 614 名（10%）患有 AF。与处于镁最低五分位数的参与者相比，处于镁最高五分位数（比值比 [OR] 0.82，95%置信区间 [CI] 0.62，1.08）、钾（OR 0.82，95%CI 0.68，1.00）和磷（OR 0.73，95%CI 0.59，0.89）的参与者的 AF 患病率较低。没有发现循环氯、钙或钠与 AF 患病率有明显关联。在 12 导联心电图中，循环钙浓度较高与 PACs 患病率较低相关，而钾、氯和钠浓度较高与 PACs 患病率较高相关。在 317 名接受延长心电图监测的参与者中，循环电解质与 PACs 或室上性心动过速的负担没有显著关联。
结论
循环电解质的浓度与某些室上性心律失常呈复杂关联。未来的研究应评估潜在的机制。
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