Department of Cardiology Kailuan General Hospital Tangshan China.
Graduate School North China University of Science and Technology Tangshan China.
J Am Heart Assoc. 2024 Aug 20;13(16):e034754. doi: 10.1161/JAHA.124.034754. Epub 2024 Aug 19.
Emerging evidence suggests a central role for inflammation in cardiac conduction disorder (CCD). It is unknown whether habitual physical activity could modulate the inflammation-associated risks of incident CCD in the general population.
This population-based cohort was derived from the China Kailuan study, including a total of 97 192 participants without prior CCD. The end points included incident CCD and its subcategories (atrioventricular block and bundle-branch block). Systemic inflammation was indicated by the monocyte-to-lymphocyte ratio (MLR). Over a median 10.91-year follow-up, 3747 cases of CCD occurred, with 1062 cases of atrioventricular block and 2697 cases of bundle-branch block. An overall linear dose-dependent relationship was observed between MLR and each study end point (all -nonlinearity≥0.05). Both higher MLR and physical inactivity were significantly associated with higher risks of conduction block. The MLR-associated risks of developing study end points were higher in the physically inactive individuals than in those being physically active, with significant interactions between MLR levels and physical activity for developing CCD (-interaction=0.07) and bundle-branch block (-interaction<0.05) found. Compared with those in MLR quartile 2 and being physically active, those in the highest MLR quartile and being physically inactive had significantly higher risks for all study end points (1.42 [95% CI, 1.24-1.63], 1.62 [95% CI, 1.25-2.10], and 1.33 [95% CI, 1.13-1.56], respectively, for incident CCD, atrioventricular block, and bundle-branch block).
MLR should be a biomarker for the risk assessment of incident CCD. Adherence to habitual physical activity is favorable for reducing the MLR-associated risks of CCD.
新出现的证据表明，炎症在心脏传导障碍（CCD）中起核心作用。目前尚不清楚习惯性体力活动是否可以调节普通人群中与炎症相关的 CCD 发病风险。
本基于人群的队列研究来源于中国开滦研究，共纳入 97192 名无先前 CCD 的参与者。终点包括 CCD 事件及其亚类（房室传导阻滞和束支传导阻滞）。单核细胞与淋巴细胞比值（MLR）表示全身炎症。在中位数为 10.91 年的随访期间，共发生 3747 例 CCD，其中 1062 例为房室传导阻滞，2697 例为束支传导阻滞。MLR 与每个研究终点之间存在总体线性剂量依赖性关系（所有非线性性≥0.05）。较高的 MLR 和体力活动不足与传导阻滞的风险增加显著相关。在体力活动不足的个体中，MLR 相关的发生研究终点的风险高于体力活动活跃的个体，发现 MLR 水平与体力活动之间对发生 CCD（-交互作用=0.07）和束支传导阻滞（-交互作用<0.05）的发展存在显著交互作用。与 MLR 四分位 2 并进行体力活动的个体相比，MLR 最高四分位且不进行体力活动的个体发生所有研究终点的风险显著更高（1.42 [95%CI，1.24-1.63]，1.62 [95%CI，1.25-2.10]和 1.33 [95%CI，1.13-1.56]，分别用于发生 CCD、房室传导阻滞和束支传导阻滞）。
MLR 应该是评估 CCD 发病风险的生物标志物。坚持习惯性体力活动有利于降低与 MLR 相关的 CCD 发病风险。
