Boccalon Bernardo, Foppa Murilo, Brant Luisa C C, Pinto Filho Marcelo M, Ribeiro Antonio L, Duncan Bruce B, Santos Angela Barreto Santiago
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil.
Hospital de Clinicas de Porto Alegre, Porto Alegre, RS - Brasil.
Arq Bras Cardiol. 2025 Jan;122(1):e20240487. doi: 10.36660/abc.20240487.
Atrial fibrillation (AF) is an arrhythmia causing significant symptoms and raising the risk of complications.
To evaluate the association of clinical, electrocardiographic, and echocardiographic parameters with prevalent atrial fibrillation or flutter (AFF) and assess the risk profile for incident AFF using the AF prediction scores CHARGE-AF and EHR in an elderly population from a developing country.
We included all participants in ELSA-Brasil aged 60 and over whose diagnosis of AFF could be defined through self-report or electrocardiogram and who had echocardiography performed at the study's baseline. For statistical analysis, results with p values < 0.05 were considered statistically significant.
Among the 2,088 participants (65 ± 4.1 years; 53% women), 88 (4.2%) had AFF. Those with AFF were older and had higher rates of heart failure (HF), previous myocardial infarction, left bundle branch block (LBBB), prolonged QT interval, supraventricular extrasystoles, and sinus bradycardia. They also had larger left atrial and left ventricular dimensions, and lower left ventricular ejection fraction (LVEF). Multivariable analysis showed that HF, LBBB, larger left atrium, and lower LVEF were independently associated with AFF. The 5-year risk for incident AFF was low (< 2.5%) in 63% and high (> 5%) in 12% of individuals according to the CHARGE-AF score, and low in 67% and high in 13% according to the EHR.
AFF was found in 4.2% of this older Brazilian cohort. AFF was linked to HF history, LBBB, left atrial dilation, and reduced LVEF. Additionally, 12% to 13% of patients in sinus rhythm were at high risk for AFF. Monitoring clinical, electrocardiographic, and echocardiographic parameters can aid in early identification of high-risk individuals.
心房颤动（AF）是一种心律失常，可导致严重症状并增加并发症风险。
在一个发展中国家的老年人群中，评估临床、心电图和超声心动图参数与心房颤动或扑动（AFF）患病率的相关性，并使用AF预测评分CHARGE-AF和电子健康记录（EHR）评估新发AFF的风险特征。
我们纳入了ELSA-Brasil研究中所有60岁及以上的参与者，其AFF诊断可通过自我报告或心电图确定，且在研究基线时进行了超声心动图检查。对于统计分析，p值<0.05的结果被认为具有统计学意义。
在2088名参与者（65±4.1岁；53%为女性）中，88人（4.2%）患有AFF。患有AFF的患者年龄更大，心力衰竭（HF）、既往心肌梗死、左束支传导阻滞（LBBB）、QT间期延长、室上性早搏和窦性心动过缓的发生率更高。他们的左心房和左心室尺寸也更大，左心室射血分数（LVEF）更低。多变量分析显示，HF、LBBB、左心房增大和LVEF降低与AFF独立相关。根据CHARGE-AF评分，63%的个体5年新发AFF风险较低（<2.5%），12%的个体风险较高（>5%）；根据EHR评分，67%的个体风险较低，13%的个体风险较高。
在这个巴西老年队列中，4.2%的人患有AFF。AFF与HF病史、LBBB、左心房扩张和LVEF降低有关。此外，12%至13%的窦性心律患者发生AFF的风险较高。监测临床、心电图和超声心动图参数有助于早期识别高危个体。
