Theunissen Luc J H J, Cremers Henricus-Paul, van Veghel Dennis, van der Voort Pepijn H, Polak Peter E, de Jong Sylvie F A M S, Smits Geert, Dijkmans Jos, Kemps Hareld M C, Dekker Lukas R C, van de Pol Jeroen A A
Máxima Medical Center Veldhoven The Netherlands.
Netherlands Heart Network Eindhoven The Netherlands.
J Arrhythm. 2022 Jan 10;38(1):50-57. doi: 10.1002/joa3.12671. eCollection 2022 Feb.
In this study, the relationship between AF-related quality of life (AFEQT) at baseline in AF-patients and the improvement on perceived symptoms and general state of health (EHRA, European Heart Rhythm Association score) at 12 months was assessed across predefined age categories.
Between November 2014 and October 2019 patients diagnosed with AF de novo in four hospitals embedded within the Netherlands Heart Network were prospectively followed for 12 months. These AF-patients were categorized into quartiles based on their AFEQT score at diagnosis and EHRA score was measured at diagnosis and 12 months of follow-up. Stratified analyses were performed using age categories (<65 vs. ≥65 years; <75 vs. ≥75 years).
In total, 203/483 (42.0%) AF-patients improved in EHRA score after 12 months of follow-up. AF-patients in the lowest AFEQT quartile were more likely to improve, compared to patients in the highest AFEQT quartile (OR [95%CI]:4.73 [2.63-8.50]). Furthermore, patients ≥65 years and patients <75 years at diagnosis with lower AFEQT scores at baseline were most likely to improve in EHRA score after 12 months, compared to similarly aged patients with higher AFEQT scores at baseline.
The present study indicates that AF-patients with a lower quality of life at diagnosis were most likely to improve their EHRA score after 12 months. This effect was most prominent in patients ≥65 years of age and patients <75 years of age, compared to patients >65 and ≥75 years, respectively. Future research should focus on further defining characteristics of these age groups to enable the implementation of age-tailored treatment.
在本研究中，我们评估了房颤患者基线时房颤相关生活质量（AFEQT）与12个月时感知症状及总体健康状况改善（欧洲心律协会EHRA评分）之间在预先定义年龄类别中的关系。
2014年11月至2019年10月期间，对荷兰心脏网络内四家医院新诊断为房颤的患者进行了为期12个月的前瞻性随访。这些房颤患者根据诊断时的AFEQT评分分为四分位数，并在诊断时和随访12个月时测量EHRA评分。使用年龄类别（<65岁与≥65岁；<75岁与≥75岁）进行分层分析。
随访12个月后，共有203/483（42.0%）的房颤患者EHRA评分有所改善。与AFEQT四分位数最高的患者相比，AFEQT四分位数最低的房颤患者更有可能改善（OR[95%CI]：4.73[2.63 - 8.50]）。此外，与基线时AFEQT评分较高的同龄患者相比，诊断时年龄≥65岁且基线时AFEQT评分较低的患者以及诊断时年龄<75岁且基线时AFEQT评分较低的患者在12个月后EHRA评分最有可能改善。
本研究表明，诊断时生活质量较低的房颤患者在12个月后最有可能改善其EHRA评分。与分别>65岁和≥75岁的患者相比，这种效应在年龄≥65岁和年龄<75岁的患者中最为显著。未来的研究应专注于进一步明确这些年龄组的特征，以实现量身定制的年龄治疗方案。
