Wei Ying, Zheng Danlei, Zhao Ning, Li Yi, Wang Chen, Cui Ming, Li Lei
Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.
Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing, China.
Medicine (Baltimore). 2025 Jul 18;104(29):e43511. doi: 10.1097/MD.0000000000043511.
The key drivers of symptom severity in atrial fibrillation (AF) patients remain unclear. The study aimed to explore associations between anxious and depressive status and AF-related symptoms as expressed by the modified European Heart Rhythm Association (mEHRA) score. The study enrolled 182 AF patients admitted to the Cardiology Department of Peking University Third Hospital between February 2017 to January 2020. Anxious and depressive status were assessed by "Generalized Anxiety Disorder-7" and "Patient Health Questionnaire-9," respectively. The severity of AF-related symptoms was scored by mEHRA and classified into 2 groups: low mEHRA group (mEHRA = 1 or 2a) and high mEHRA group (mEHRA ≥ 2b), according to whether they were troubled or affected by AF-related symptoms. In all 182 AF patients, 56.0% (n = 102) patients presented mEHRA ≥ 2b. The high mEHRA group had significantly higher Patient Health Questionnaire-9 score [4.0 (2.0-7.0) vs 2.5 (0-4.8), P < .001] and Generalized Anxiety Disorder-7 score [3 (0-5) vs 0 (0-3), P < .001]. After adjusted for other covariates, persistent AF (odds ratio, OR = 0.48, 95% confidence interval [CI]: 0.23, 0.99), heart failure (OR = 2.91, 95% CI: 1.08, 8.43), depressive status (OR = 2.15, 95% CI: 1.01, 4.65), and anxious status (OR = 2.83, 95% CI: 1.17, 7.38) were independently associated with high mEHRA score (≥2b). Increased anxiety and depression levels was associated with feeling troubled or limited by AF-related symptoms scored by mEHRA.
心房颤动（AF）患者症状严重程度的关键驱动因素仍不明确。本研究旨在探讨焦虑和抑郁状态与改良欧洲心律协会（mEHRA）评分所表示的房颤相关症状之间的关联。该研究纳入了2017年2月至2020年1月期间北京大学第三医院心内科收治的182例房颤患者。焦虑和抑郁状态分别通过“广泛性焦虑障碍量表-7”和“患者健康问卷-9”进行评估。房颤相关症状的严重程度通过mEHRA评分，并根据患者是否受到房颤相关症状的困扰或影响分为两组：低mEHRA组（mEHRA = 1或2a）和高mEHRA组（mEHRA≥2b）。在全部182例房颤患者中，56.0%（n = 102）的患者mEHRA≥2b。高mEHRA组的患者健康问卷-9评分[4.0（2.0 - 7.0）对2.5（0 - 4.8），P <.001]和广泛性焦虑障碍量表-7评分[3（0 - 5）对0（0 - 3），P <.001]显著更高。在对其他协变量进行校正后，持续性房颤（比值比，OR = 0.48, 95%置信区间[CI]：0.23, 0.99）、心力衰竭（OR = 2.91, 95% CI：1.08, 8.43）、抑郁状态（OR = 2.15, 95% CI：1.01, 4.65）和焦虑状态（OR = 2.83, 95% CI：1.17, 7.38）与高mEHRA评分（≥2b）独立相关。焦虑和抑郁水平的升高与mEHRA评分所表示的房颤相关症状的困扰或受限感有关。
