Wang Bing, Yang Xinglin, Wei Bo, Ren Tingting, Huang Niwen, Escobar Carlos, Pang Philip Y K, Liu Xingde, Zhou Haiyan
Department of Cardiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
Department of Internal Medicine, School of Clinical Medicine, Guizhou Medical University, Guiyang, China.
J Thorac Dis. 2024 Mar 29;16(3):2049-2059. doi: 10.21037/jtd-24-170. Epub 2024 Mar 27.
Reportedly, there is a clear correlation between waist circumference (WC) and atrial fibrillation (AF). However, there is no specific discussion about the relationship between WC and non-valvular AF (NVAF) patients with heart failure. Our main purpose was to study the relationship between WC, central obesity (CO), and NVAF patients with heart failure.
This is a retrospective cohort study. A total of 3,435 patients with NVAF in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2017 were enrolled. The targeted independent variable and the dependent variable were WC and CO and the presence of NVAF with heart failure, respectively. Univariate, multiple regression, and subgroup analyses were used to analyze their relationship. We used the receiver operating characteristic (ROC) curve to choose the better predictor of NVAF with heart failure between WC and CO and calculated the proposed cut-off value of WC in males and female separately.
The identified risk factors of NVAF with heart failure were sex, height, WC, CO, body mass index (BMI), fasting blood glucose (FBG), homocysteine (HCY), triglyceride (TG), low-density lipoprotein cholesterol (LDLC), hypertension, diabetes mellitus (DM), stroke, vascular disease, and plaque. Then, a binary logistic regression model indicated that the occurrence of NVAF patients with heart failure increased 10% with WC increasing 1 cm and had a 2.8-fold increased risk with CO compared to those without. The predictive value [area under the ROC curve (AUC)], specificity, sensitivity, and accuracy of WC for the disease risk of NVAF with heart failure were higher than those of CO. The proposed cut-off value of WC was 91.85 cm for males and 93.15 cm for females. The diagnostic value of WC for NVAF with heart failure was higher for females than it was for males.
Our research found that WC is related to the presence of heart failure in the patients with NYAF and can predict the presence of NVAF with heart failure. Our findings may help to improve the treatment and care strategies of NVAF individuals with abdominal obesity.
据报道，腰围（WC）与心房颤动（AF）之间存在明显的相关性。然而，关于WC与心力衰竭的非瓣膜性心房颤动（NVAF）患者之间的关系尚无具体讨论。我们的主要目的是研究WC、中心性肥胖（CO）与心力衰竭的NVAF患者之间的关系。
这是一项回顾性队列研究。纳入了2015年1月至2017年12月在新疆医科大学第一附属医院的3435例NVAF患者。目标自变量和因变量分别为WC、CO以及心力衰竭的NVAF的存在情况。采用单因素、多元回归和亚组分析来分析它们之间的关系。我们使用受试者工作特征（ROC）曲线来选择WC和CO中对心力衰竭的NVAF更好的预测指标，并分别计算男性和女性WC的建议截断值。
确定的心力衰竭的NVAF的危险因素包括性别、身高、WC、CO、体重指数（BMI）、空腹血糖（FBG）、同型半胱氨酸（HCY）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDLC）、高血压、糖尿病（DM）、中风、血管疾病和斑块。然后，二元逻辑回归模型表明心力衰竭的NVAF患者的发生率随WC每增加1 cm而增加10%，与无CO的患者相比，CO患者的风险增加2.8倍。WC对心力衰竭的NVAF疾病风险的预测价值[ROC曲线下面积（AUC）]、特异性、敏感性和准确性高于CO。建议的WC截断值男性为91.85 cm，女性为93.15 cm。WC对女性心力衰竭的NVAF的诊断价值高于男性。
我们的研究发现WC与NYAF患者心力衰竭的存在有关，并且可以预测心力衰竭的NVAF的存在。我们的研究结果可能有助于改善腹部肥胖的NVAF个体的治疗和护理策略。
