Long Tianxin, Wu Xiaoying, Chen Yongming, Fu Bingqi, Cheng Sijing, Huang Hao, Niu Hongxia, Hua Wei
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Peking University Fifth School of Clinical Medicine, Beijing Hospital, National Center of Gerontology, Beijing, China.
Eur J Prev Cardiol. 2025 Feb 20. doi: 10.1093/eurjpc/zwaf089.
To evaluate the effect of Life's Essential 8 (LE8), a comprehensive cardiovascular health (CVH) metric from the American Heart Association, on the risk of cardiac conduction disorders (CCD).
We conducted a prospective cohort study of 112,160 adults from the UK Biobank, free of cardiovascular disease at baseline, to examine the association between LE8 scores and the risk of CCD. LE8 scores were categorized into low (0-49), moderate (50-79), and high (80-100) CVH groups. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CCD incidence during a median follow-up of 11.6 years. A total of 2,760 CCD cases were identified. After adjustment for confounders, the high CVH group exhibited a significantly lower risk of CCD compared to the low CVH group (HR: 0.48, 95% CI: 0.40-0.56). Further analyses showed reduced risks for both severe conduction block (HR: 0.63, 95% CI: 0.52-0.78) and left bundle branch or fascicular block (HR: 0.35, 95% CI: 0.25-0.49) in the high CVH group. Restricted cubic spline regression revealed an L-shaped association between LE8 score and CCD risk. Among individual LE8 metrics, WQS analysis revealed that BMI and sleep health were the major contributors to reduced CCD risk.
Higher LE8 scores were associated with a lower risk of CCD, including severe conduction block requiring pacemaker implantation and left bundle branch or fascicular block. Comprehensive strategies targeting optimal CVH, especially BMI and sleep health, may be beneficial for preventing CCD.
评估美国心脏协会的综合心血管健康指标“生命关键8要素”（LE8）对心脏传导障碍（CCD）风险的影响。
我们对英国生物银行的112160名成年人进行了一项前瞻性队列研究，这些成年人在基线时无心血管疾病，以研究LE8评分与CCD风险之间的关联。LE8评分被分为低（0 - 49）、中（50 - 79）和高（80 - 100）心血管健康组。使用Cox比例风险模型估计在中位随访11.6年期间CCD发病率的风险比（HRs）和95%置信区间（CIs）。共识别出2760例CCD病例。在对混杂因素进行调整后，高心血管健康组与低心血管健康组相比，CCD风险显著降低（HR：0.48，95% CI：0.40 - 0.56）。进一步分析显示，高心血管健康组严重传导阻滞（HR：0.63，95% CI：0.52 - 0.78）和左束支或分支阻滞（HR：0.35，95% CI：0.25 - 0.49）的风险均降低。受限立方样条回归显示LE8评分与CCD风险之间呈L形关联。在各个LE8指标中，加权分位数和回归分析显示体重指数（BMI）和睡眠健康是降低CCD风险的主要因素。
较高的LE8评分与较低的CCD风险相关，包括需要植入起搏器的严重传导阻滞以及左束支或分支阻滞。针对最佳心血管健康的综合策略，尤其是BMI和睡眠健康，可能有助于预防CCD。
