Wang Haiyan, Liu Sitong, Zhang Xilin, Zheng Jianpeng, Lu Feng, Lip Gregory Y H, Bai Ying
Department of Neurology and Psychiatry, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100051, China.
J Clin Med. 2023 Feb 3;12(3):1236. doi: 10.3390/jcm12031236.
Data on the outcomes of restrictive cardiomyopathy (RCM) are limited, when the condition is complicated with arrhythmia. This study was designed to investigate the prevalence of atrial fibrillation (AF), ventricular tachycardia (VT) and bradycardia (BC) and their impact on adverse outcomes (intra-cardiac thrombus, stroke and systematic embolism [SSE], heart failure and death) of RCM.
The retrospective cohort study used data collected from the Beijing Municipal Health Commission Information Center (BMHCIC) database from 1 January 2010 to 31 December 2020. There were 745 (64.9%) patients with AF, 117 (10.2%) patients with VT and 311 (27.1%) patients with bradycardia. The presence of AF was associated with an increased risk of SSE (adjusted HR:1.37, 95%CI:1.02-1.83, = 0.04) and heart failure (aHR:1.36, 95%CI:1.17-1.58, < 0.001). VT was associated with an increased risk of intracardiac thrombus (aHR:2.34, 95%CI:1.36-4.01, = 0.002) and death (aHR:2.07, 95%CI:1.19-3.59, = 0.01). Bradycardia did not increase the adverse outcomes in RCM. The results remained consistent and steady when AF, VT and bradycardia were adjusted as competing factors.
Cardiac arrhythmia are highly prevalent and associated with adverse outcomes in patients with RCM. AF and VT are more likely to be associated with intracardiac thrombosis, and the presence of AF increased the risk of SSE and HF. The presence of VT increased the risk of death.
当限制型心肌病(RCM)合并心律失常时,关于其预后的数据有限。本研究旨在调查心房颤动(AF)、室性心动过速(VT)和心动过缓(BC)的患病率及其对RCM不良结局(心内血栓、中风和系统性栓塞[SSE]、心力衰竭和死亡)的影响。
这项回顾性队列研究使用了从北京市卫生健康委员会信息中心(BMHCIC)数据库收集的2010年1月1日至2020年12月31日的数据。有745例(64.9%)AF患者、117例(10.2%)VT患者和311例(27.1%)心动过缓患者。AF的存在与SSE风险增加相关(校正后HR:1.37,95%CI:1.02-1.83,P = 0.04)和心力衰竭(校正后HR:1.36,95%CI:1.17-1.58,P < 0.001)。VT与心内血栓风险增加相关(校正后HR:2.34,95%CI:1.36-4.01,P = 0.002)和死亡(校正后HR:2.07,95%CI:1.19-3.59,P = 0.01)。心动过缓并未增加RCM的不良结局。当将AF、VT和心动过缓作为竞争因素进行校正时,结果保持一致且稳定。
心律失常在RCM患者中高度普遍且与不良结局相关。AF和VT更有可能与心内血栓形成相关,且AF的存在增加了SSE和HF的风险。VT的存在增加了死亡风险。