Department of Cardiology, Faculty of Medicine, Ufuk University, Ankara, Turkey.
Department of Cardiology, Gulhane Education and Research Hospital, Ankara, Turkey.
Med Princ Pract. 2022;31(4):368-375. doi: 10.1159/000524396. Epub 2022 Apr 8.
Malnutrition is associated with cardiovascular disease morbidity and mortality. Arrhythmias may be the cardiac consequences of malnutrition.
The objective of the study was to evaluate the association between prognostic nutritional index (PNI), Controlling Nutritional Status (CONUT) score, and arrhythmic events on 24-h electrocardiography (ECG) Holter recording in patients without manifested arrhythmia.
In this retrospective analysis of 477 patients who underwent 24-h ECG Holter monitoring, PNI and CONUT score were calculated and patients were divided into tertiles according to PNI and into three groups according to CONUT score; 0: normal, 1-2: mild risk of malnutrition, ≥3: moderate-severe risk of malnutrition. Arrhythmic events were compared between PNI tertiles and CONUT score groups.
Total number of premature atrial contractions, premature ventricular contractions (PVCs), PVC burden, and incidence of paroxysmal atrial fibrillation (PAF) were significantly higher in patients within the lowest PNI tertile. Total number of PVCs, PVC burden, and incidence of PAF were significantly higher in patients with CONUT score ≥3. The cut-off value for PNI to predict the presence of PVC was defined as 39.41 using ROC curve analysis. The area under the curve was 0.650 (p < 0.001). Multivariate analysis showed that PNI was independent predictor of the presence of PVC and PAF. Also, CONUT score was independent predictor of the presence of PVC and PAF. Incidence of nonsustained ventricular tachycardia did not differ between PNI tertiles or CONUT score groups.
Poor nutritional status, assessed by PNI and CONUT score, is associated with arrhythmic events on 24-h ECG Holter recording in patients without manifested arrhythmia.
营养不良与心血管疾病的发病率和死亡率有关。心律失常可能是营养不良的心脏后果。
本研究的目的是评估预后营养指数（PNI）、控制营养状况（CONUT）评分与无明显心律失常患者 24 小时心电图（ECG）动态心电图记录中心律失常事件之间的关系。
在这项对 477 例接受 24 小时 ECG 动态心电图监测的患者进行的回顾性分析中，计算了 PNI 和 CONUT 评分，并根据 PNI 将患者分为三分位，根据 CONUT 评分将患者分为三组；0：正常，1-2：轻度营养不良风险，≥3：中重度营养不良风险。比较了 PNI 三分位和 CONUT 评分组之间的心律失常事件。
最低 PNI 三分位组患者的总房性期前收缩数、室性期前收缩（PVC）数、PVC 负荷和阵发性心房颤动（PAF）发生率明显更高。CONUT 评分≥3 的患者的 PVC 总数、PVC 负荷和 PAF 发生率明显更高。使用 ROC 曲线分析定义 PNI 预测 PVC 存在的截断值为 39.41。曲线下面积为 0.650（p<0.001）。多变量分析表明，PNI 是 PVC 和 PAF 存在的独立预测因子。此外，CONUT 评分是 PVC 和 PAF 存在的独立预测因子。PNI 三分位或 CONUT 评分组之间非持续性室性心动过速的发生率无差异。
PNI 和 CONUT 评分评估的营养状况不佳与无明显心律失常患者 24 小时心电图动态心电图记录中的心律失常事件相关。
