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估计脉搏波速度可预测新发房颤的发生率:一项针对中国人群的11年前瞻性研究。

Estimated pulse wave velocity can predict the incidence of new-onset atrial fibrillation: A 11-year prospective study in a Chinese population.

作者信息

Chen Haojia, Chen Guanzhi, Zhang Liling, Wu Weiqiang, Li Weijian, Wang Xianxuan, Yan Xiuzhu, Chen Youren, Wu Shouling

机构信息

Shantou University Medical College, Shantou, China.

Department of Cardiology, First Hospital of Medical College of Shantou University, Shantou, China.

出版信息

Front Cardiovasc Med. 2022 Aug 22;9:912573. doi: 10.3389/fcvm.2022.912573. eCollection 2022.

Abstract

BACKGROUND

Arterial stiffness, a risk factor for atrial fibrillation (AF), is rarely applied in clinical practice because of the difficulty and high cost of its measurement. Estimated pulse wave velocity (ePWV) is a simple, reproducible, and non-invasive index of arterial stiffness. This study was to assess the predictive value of ePWV for the risk of new-onset AF.

METHODS

Subjects were selected from the Kailuan cohort study population who underwent initial physical examination between 2006 and 2008. A total of 96,561 subjects were ultimately included in the final analysis. ePWV was divided into four groups according to quartiles. The Kaplan-Meier method was used to calculate the cumulative incidence of AF. A Cox regression model was used to assess the predictive value of estimated arterial stiffness for new-onset AF.

RESULTS

Mean age of subjects was 51.47 ± 9.68 years, while 76,968 (79.65%) were male and 19,663 (20.35%) were female. During mean follow-up period of 11.77 years, 1,215 AF events occurred. Results of the Kaplan-Meier analysis showed that the incidence of new-onset AF increased with increase in ePWV. Cox regression analysis showed that in the total population, the incidence of new-onset AF was 1.64, 1.90, and 2.64 times higher in the medium, medium-high, and high ePWV groups, respectively, compared with the low ePWV group. When stratified according to sex, ePWV had higher predictive value in the female population.

CONCLUSIONS

Increased ePWV increases the incidence of new-onset AF, and may promote application of more aggressive primary prevention.

TRIAL REGISTRY NAME

Risk factors and intervention for cardiology, cerebrovascular and related disease (Kailuan Study); URL: http://www.chictr.org.cn/showproj.aspx?proj=8050; Registration number: ChiCTR-TNRC-11001489.

摘要

背景

动脉僵硬度是心房颤动(AF)的一个危险因素,但由于其测量困难且成本高,在临床实践中很少应用。估计脉搏波速度(ePWV)是一种简单、可重复且无创的动脉僵硬度指标。本研究旨在评估ePWV对新发房颤风险的预测价值。

方法

从2006年至2008年接受初次体检的开滦队列研究人群中选取受试者。最终共有96561名受试者纳入最终分析。ePWV根据四分位数分为四组。采用Kaplan-Meier法计算房颤的累积发病率。使用Cox回归模型评估估计的动脉僵硬度对新发房颤的预测价值。

结果

受试者的平均年龄为51.47±9.68岁,其中男性76968人(79.65%),女性19663人(20.35%)。在平均随访11.77年期间,发生了1215例房颤事件。Kaplan-Meier分析结果显示,新发房颤的发生率随ePWV的增加而增加。Cox回归分析表明,在总体人群中,与低ePWV组相比,中、中高和高ePWV组新发房颤的发生率分别高1.64倍、1.90倍和2.64倍。按性别分层时,ePWV在女性人群中具有更高的预测价值。

结论

ePWV升高会增加新发房颤的发生率,并可能促进更积极的一级预防措施的应用。

试验注册名称

心血管、脑血管及相关疾病的危险因素与干预(开滦研究);网址:http://www.chictr.org.cn/showproj.aspx?proj=8050;注册号:ChiCTR-TNRC-11001489。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c32/9443485/b9f9985131f3/fcvm-09-912573-g0001.jpg

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