心房颤动导致心动过速诱发心肌病的风险因素

Koji Yasumoto, Yasuyuki Egami, Hiroaki Nohara, Shodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga‐Lee, Masamichi Yano, Masami Nishino, Jun Tanouchi
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Non‐TIC was defined as LVEF ≥ 50% despite AF rhythm. The patient backgrounds were compared between the TIC group and the non‐TIC group to reveal the contributing factors of TIC.ResultsThe TIC group comprised 57 patients, while the non‐TIC group consisted of 101 patients. The TIC group was younger than the non‐TIC group (median 64 vs. 70, <jats:italic>p</jats:italic> = 0.006). Male sex was more frequent in the TIC group than the non‐TIC group (82.5% vs. 58.4%, <jats:italic>p</jats:italic> = 0.003). HR was higher in the TIC group than in the non‐TIC group (median 130 bpm vs. 111 bpm, <jats:italic>p</jats:italic> &lt; 0.001). The number of smokers was significantly higher in the TIC group than in the non‐TIC group (<jats:italic>p</jats:italic> &lt; 0.001). 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摘要

背景心动过速诱发的心肌病(TIC)是一种由快速性心律失常导致心室功能障碍的可逆性心肌病。值得注意的是,心房颤动(房颤)是导致 TIC 最常见的致病性心律失常。然而,房颤导致 TIC 的风险因素仍不明确。本研究旨在确定心房颤动导致 TIC 的相关因素。方法 本研究纳入了心率(HR)≥100 次/分且接受了初次导管消融术的持续性心房颤动患者。房颤节律期间左心室射血分数(LVEF)为 50%,恢复窦性心律后左心室射血分数恢复正常。非 TIC 的定义是尽管有房颤节律,但 LVEF 仍≥50%。对 TIC 组和非 TIC 组的患者背景进行比较,以揭示导致 TIC 的因素。TIC 组比非 TIC 组年轻(中位数 64 对 70,P = 0.006)。男性在 TIC 组中的比例高于非 TIC 组(82.5% 对 58.4%,P = 0.003)。TIC 组的心率高于非 TIC 组(中位数为 130 bpm 对 111 bpm,p = 0.001)。TIC 组的吸烟人数明显高于非 TIC 组(p < 0.001)。多变量分析表明,HR 较高(赔率比 [OR]:1.74; 95% 置信区间 [CI]:结论较高的心率和当前吸烟者是心房颤动导致 TIC 发生的独立危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors for tachycardia‐induced cardiomyopathy due to atrial fibrillation
BackgroundTachycardia‐induced cardiomyopathy (TIC) is a reversible cardiomyopathy with ventricular dysfunction caused by tachyarrhythmias. Notably, atrial fibrillation (AF) is the most common causal arrhythmia leading to TIC. However, the risk factors for the development of TIC due to AF remain unclear. This study aimed to identify the associated factors of TIC due to AF.MethodsPersistent AF patients with heart rate (HR) ≥100 beats per minute who underwent initial catheter ablation were enrolled in this study. TIC was diagnosed as left ventricular ejection fraction (LVEF) < 50% during AF rhythm, which was recovered after the restoration of sinus rhythm. Non‐TIC was defined as LVEF ≥ 50% despite AF rhythm. The patient backgrounds were compared between the TIC group and the non‐TIC group to reveal the contributing factors of TIC.ResultsThe TIC group comprised 57 patients, while the non‐TIC group consisted of 101 patients. The TIC group was younger than the non‐TIC group (median 64 vs. 70, p = 0.006). Male sex was more frequent in the TIC group than the non‐TIC group (82.5% vs. 58.4%, p = 0.003). HR was higher in the TIC group than in the non‐TIC group (median 130 bpm vs. 111 bpm, p < 0.001). The number of smokers was significantly higher in the TIC group than in the non‐TIC group (p < 0.001). Multivariable analysis demonstrated that higher HR (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.37–2.21; p < 0.001) and current smokers (OR: 5.27; 95% CI: 1.60–17.4; p = 0.006) were the independent factors leading to TIC.ConclusionHigher HR and current smokers were independent risk factors for the development of TIC due to AF.
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