The Yancheng Clinical College of Xuzhou Medical University, Yancheng, 224001, China.
The First people's Hospital of Yancheng, Yancheng, 224001, China.
J Cardiothorac Surg. 2024 Oct 4;19(1):591. doi: 10.1186/s13019-024-03097-9.
Atrial fibrillation (AF) has emerged as a notable public health issue in China due to the aging population and rapid urbanization. This study aimed to describe the characteristics of patients with AF (paroxysmal and nonparoxysmal) and investigate the association between left ventricular ejection fraction (LVEF) levels and AF subtypes to facilitate early prevention in patients with AF.
Patients with AF who presented at the cardiology department of the First People's Hospital of Yancheng were recruited in this study. In univariate and multivariate logistic regression analyses, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the relationships between each dependent variable and nonparoxysmal AF. The restricted cubic splines (RCS) curve was employed to explore the linear relationship between LVEF and nonparoxysmal AF on a continuous scale. Subgroup analysis was applied to examine the stability of the results.
The study included a total of 2054 patients who were diagnosed with AF. 652 (31.74%) patients had paroxysmal AF, and 1402 (68.26%) had nonparoxysmal AF. Multivariate logistic regression analyses indicated that compared to those with paroxysmal AF, patients with nonparoxysmal AF tended to have a higher prevalence of coronary artery disease, lower levels of LVEF, and an elevated heart rate. Additionally, RCS curves also showed that LVEF was negatively and linearly associated with the nonparoxysmal AF. Furthermore, the association between LVEF and nonparoxysmal AF was stronger among patients with hypertension and obesity (P for interaction < 0.05).
Patients with nonparoxysmal AF have a more advanced AF burden and the transition from paroxysmal to nonparoxysmal AF should be recognized in time, especially to treat the corresponding comorbidities (including hypertension and obesity) more consistently.
由于人口老龄化和快速城市化，心房颤动（AF）已成为中国一个显著的公共卫生问题。本研究旨在描述 AF（阵发性和非阵发性）患者的特征，并研究左心室射血分数（LVEF）水平与 AF 亚型之间的关系，以便为 AF 患者的早期预防提供依据。
本研究纳入了在盐城市第一人民医院心内科就诊的 AF 患者。采用单因素和多因素 logistic 回归分析，计算比值比（OR）和 95%置信区间（CI），以评估各因变量与非阵发性 AF 之间的关系。采用受限立方样条（RCS）曲线探索 LVEF 与非阵发性 AF 之间的连续尺度线性关系。进行亚组分析以检验结果的稳定性。
该研究共纳入 2054 例诊断为 AF 的患者。其中 652 例（31.74%）患者为阵发性 AF，1402 例（68.26%）为非阵发性 AF。多因素 logistic 回归分析表明，与阵发性 AF 患者相比，非阵发性 AF 患者更易患冠状动脉疾病，LVEF 水平更低，心率更高。此外，RCS 曲线也显示 LVEF 与非阵发性 AF 呈负线性相关。此外，在高血压和肥胖患者中，LVEF 与非阵发性 AF 之间的关联更强（P 交互<0.05）。
非阵发性 AF 患者的 AF 负担更重，应及时认识到从阵发性到非阵发性 AF 的转变，特别是更一致地治疗相应的合并症（包括高血压和肥胖）。
