甲状腺功能障碍与肥厚型梗阻性心肌病患者心房颤动发生率的关系。
Association Between Thyroid Dysfunction and Incidence of Atrial Fibrillation in Patients With Hypertrophic Obstructive Cardiomyopathy.
机构信息
Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China.
Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Front Endocrinol (Lausanne). 2022 Jul 4;13:875003. doi: 10.3389/fendo.2022.875003. eCollection 2022.
OBJECTIVE
To explore the correlation between the incidence of atrial fibrillation (AF) and thyroid dysfunction in patients with hypertrophic obstructive cardiomyopathy (HOCM).
METHODS
Thyroid function testing in 755 consecutive patients with HOCM were examined at the National Center for Cardiovascular Diseases (China) from October 2009 to December 2013. Patients were divided into four groups according to the TSH levels: TSH<0.55 mIU/L(n=37)、0.552.49 mIU/L (n=490)、2.509.9 mIU/L (n=211) and >10.00mIU/L(n=17).
RESULTS
A total of 107 patients were diagnosed with AF (14%).(1) Compared to HOCM patients without AF,HOCM patients with AF have older age (P<0.001), higher NT-proBNP (P=0.002), higher Cr (P=0.005), larger left atrial diameter(P=0.001), lower FT3 (P=0.046), higher FT4 (P=0.004).(2) In the four groups according to the TSH levels: TSH<0.55 mIU/L, 0.552.49mIU/L, 2.509.9mIU/L and ≥10.00mIU/L, the incidence of AF was 27.02%(10/37),10.20%(50/490), 19.43%(41/211), and 35.29%(6/17), respectively. Both high and low TSH levels were associated with an increased incidence of AF. After adjusting for the common risk factor (age, NT-proBNP, and so on), stepwise multiple logistic regression analysis revealed that TSH levels were significantly related to AF incidence.Compared to patients with TSH 0.552.49 mlU/L, the adjusted odds ratio of AF for TSH<0.55, 2.509.99, ≥10.00 mIU/L were 1.481 (95% CI 0.4854.518,P=0.490), 1.977 (95%CI 1.1153.506, p=0.02), 4.301 (95%CI 1.059~17.476, P=0.041), respectively.
CONCLUSION
Our results suggested that thyroid dysfunction was associated with an increased risk of AF in patients with HOCM.
目的
探讨肥厚型梗阻性心肌病（HOCM）患者心房颤动（AF）的发生率与甲状腺功能障碍之间的关系。
方法
2009 年 10 月至 2013 年 12 月，在中国国家心血管疾病中心对 755 例连续 HOCM 患者进行了甲状腺功能检测。根据 TSH 水平将患者分为四组：TSH<0.55mIU/L（n=37）、0.552.49mIU/L（n=490）、2.509.9mIU/L（n=211）和>10.00mIU/L（n=17）。
结果
共有 107 例患者被诊断为 AF（14%）。（1）与无 AF 的 HOCM 患者相比，有 AF 的 HOCM 患者年龄更大（P<0.001），NT-proBNP 更高（P=0.002），Cr 更高（P=0.005），左心房直径更大（P=0.001），FT3 更低（P=0.046），FT4 更高（P=0.004）。（2）在根据 TSH 水平分为四组的患者中：TSH<0.55mIU/L、0.552.49mIU/L、2.509.9mIU/L 和≥10.00mIU/L，AF 的发生率分别为 27.02%（10/37）、10.20%（50/490）、19.43%（41/211）和 35.29%（6/17）。高和低 TSH 水平均与 AF 发生率增加相关。在调整常见风险因素（年龄、NT-proBNP 等）后，逐步多元逻辑回归分析表明，TSH 水平与 AF 发生率显著相关。与 TSH 0.552.49mlU/L 的患者相比，TSH<0.55、2.509.99、≥10.00mIU/L 的 AF 调整比值比分别为 1.481（95%CI 0.4854.518，P=0.490）、1.977（95%CI 1.1153.506，p=0.02）、4.301（95%CI 1.059~17.476，P=0.041）。
结论
我们的结果表明，甲状腺功能障碍与 HOCM 患者 AF 风险增加有关。
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