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COPD 加重期住院患者阵发性心房颤动和心律失常的患病率及相关因素。

Prevalence and Associated Factors of Paroxysmal Atrial Fibrillation and Atrial Arrhythmias During Hospitalizations for Exacerbation of COPD.

机构信息

Cardiovascular Department, Hanoi Medical University, Hanoi City, Vietnam.

Cardiovascular Center, Hanoi Medical University Hospital, Hanoi City, Vietnam.

出版信息

Int J Chron Obstruct Pulmon Dis. 2024 Sep 4;19:1989-2000. doi: 10.2147/COPD.S473289. eCollection 2024.

Abstract

PURPOSE

This study aimed to investigate the proportion and risk factors of paroxysmal atrial fibrillation (AF) and atrial arrhythmias (AA) in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Vietnam.

PATIENTS AND METHODS

A prospective observational study was conducted at two major hospitals in Hanoi, Vietnam, from January 2022 to January 2023. A total of 197 AECOPD patients were recruited. ECG and 24-hour Holter ECG were used to diagnose paroxysmal AF and AA.

RESULTS

The prevalence of paroxysmal AF and AA were 15.2% and 72.6%, respectively. Factors associated with a higher likelihood of paroxysmal AF included aging 75 years old and above (aOR = 3.15; 95% CI: 1.28 to 8.48), Premature atrial complex (PAC) with 500 or more (aOR = 3.81; 95% CI: 1.48 to 10.97) and severity of COPD as group C and D (aOR = 3.41; 95% CI: 1.28 to 10.50). For AA, aging 75 years old and above (aOR = 2.25; 95% CI: 1.28 to 5.20), smoking (aOR = 2.10; 95% CI: 1.07 to 4.23) and P wave dispersion (PWD) with 40 milliseconds or more (aOR = 3.04; 95% CI: 1.54 to 6.19) were associated with a higher likelihood of AA.

CONCLUSION

Overall, our findings highlight the associated factors with the paroxysmal AF and AA among AECOPD patients. This underscores the importance of a multifaceted approach to risk assessment and management in this vulnerable population, focusing not only on respiratory symptoms but also on comprehensive cardiovascular evaluation and intervention.

摘要

目的

本研究旨在调查越南因慢性阻塞性肺疾病急性加重(AECOPD)住院患者阵发性心房颤动(AF)和心房心律失常(AA)的比例和相关因素。

方法

这是一项在越南河内的两家主要医院进行的前瞻性观察性研究。研究时间为 2022 年 1 月至 2023 年 1 月,共纳入 197 名 AECOPD 患者。采用心电图和 24 小时动态心电图诊断阵发性 AF 和 AA。

结果

阵发性 AF 和 AA 的患病率分别为 15.2%和 72.6%。与阵发性 AF 发生相关的因素包括年龄 75 岁及以上(优势比[OR] = 3.15;95%置信区间[CI]:1.28 至 8.48)、500 个以上房性期前收缩(PAC)(OR = 3.81;95%CI:1.48 至 10.97)和 COPD 严重程度为 C 组和 D 组(OR = 3.41;95%CI:1.28 至 10.50)。AA 发生相关的因素包括年龄 75 岁及以上(OR = 2.25;95%CI:1.28 至 5.20)、吸烟(OR = 2.10;95%CI:1.07 至 4.23)和 P 波离散度(PWD)40 毫秒或更长(OR = 3.04;95%CI:1.54 至 6.19)。

结论

总的来说,我们的研究结果强调了 AECOPD 患者中阵发性 AF 和 AA 的相关因素。这突显了在这一脆弱人群中进行多方面的风险评估和管理的重要性,不仅要关注呼吸症状,还要全面评估心血管状况并进行干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d19/11380853/f589636460f5/COPD-19-1989-g0001.jpg

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