Wan Shuang, Zheng Chengcheng, Chen Tao, Tan Lu, Tang Jia, Tian Haoming, Ren Yan
Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
Department of Endocrinology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
Endocr Connect. 2023 Nov 14;12(12). doi: 10.1530/EC-23-0359. Print 2023 Dec 1.
We applied 24-h Holter monitoring to analyze the characteristics of arrhythmias and heart rate variability in Chinese patients with primary aldosteronism (PA) and compared them with age-, sex-, and blood pressure-matched primary hypertension (PH) patients. A total of 216 PA patients and 261 PH patients were enrolled. The nonstudy data were balanced using propensity score matching (PSM), and the risk variables for developing arrhythmias were then analyzed using logistic regression analysis. Before PSM, the proportion of PA patients with combined atrial premature beats and prolonged QT interval was higher than the corresponding proportion in the PH group. After PSM, the PA group had a larger percentage of transient atrial tachycardia and frequent atrial premature beats, and it had higher heart rate variability metrics. The proportion of unilateral PA combined with multiple ventricular premature beats was higher than that of bilateral PA. Older age, grade 3 hypertension, and hypokalemia were independent risk factors for the emergence of arrhythmias in PA patients. PA patients suffer from a greater prevalence of arrhythmias than well-matched PH patients.
我们应用24小时动态心电图监测来分析中国原发性醛固酮增多症(PA)患者的心律失常特征和心率变异性,并将其与年龄、性别和血压匹配的原发性高血压(PH)患者进行比较。共纳入216例PA患者和261例PH患者。使用倾向评分匹配(PSM)平衡非研究数据,然后使用逻辑回归分析心律失常的风险变量。在PSM之前,合并房性早搏和QT间期延长的PA患者比例高于PH组的相应比例。PSM后,PA组短暂性房性心动过速和频发房性早搏的百分比更高,且心率变异性指标更高。单侧PA合并多个室性早搏的比例高于双侧PA。年龄较大、3级高血压和低钾血症是PA患者出现心律失常的独立危险因素。PA患者心律失常的患病率高于匹配良好的PH患者。