微心房颤动患者的钠尿肽浓度和超声心动图检查结果

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2024-08-31 DOI:10.18087/cardio.2024.8.n2633

Hüseyin Aykaç, Cihan Aydın, Aykut Demirkıran, Nurullah Uslu, Şeref Alpsoy

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引用次数: 0

摘要

目的：心房颤动（AF）是一种心律失常，其特点是心房源性电激活非常快且无序，心房收缩不协调。极短时间的房颤样活动（微房颤）可能是未被发现的无声房颤发作的前兆。在此，我们研究了微房颤患者体内钠尿肽浓度与超声心动图结果之间的关系：用 24 小时 Holter 监护仪记录心悸患者的心电图，并将患者连续纳入研究。微心房颤动的定义是持续时间少于 30 秒的突发性不规则房性心动过速，发作次数≥5 次连续室上性去极化，且绝对没有 p 波。经过 G 功率测试后，患者被连续纳入研究：微 AF 组和对照组各 45 名患者。两组患者的实验室指标、心电图和超声心动图结果进行了比较：结果：微 AF 组 N 端 Pro B 型钠尿肽（Pro-BNP）和血清肌钙蛋白 T 浓度更高（分别为 375.5±63.6 pg / ml vs. 63.1±56.8 pg / ml，p<0.001；13±11.4 ng / dl vs. 4.4±2.4 ng / dl，p<0.001）。血清 Pro-BNP 每增加 1 pg / ml，微 AF 风险增加 1.8%。在 ROC 分析中，Pro-BNP 诊断微小心房颤动的临界值为 63.4 pg /ml，敏感性为 91.1%，特异性为 73.3%。微 AF 组的心房电动力学延迟时间明显较长。要预测微 AF，心房间平面机电延迟时间（心房间平面 AEMD）的临界值为 18.5 秒，灵敏度为 93.3%，特异度为 91.1%。左心房内平面机电延迟时间（心房内 AEMD LEFT）的临界值为 11.5 秒，灵敏度为 95.6%，特异度为 75.6%。在心电图评估中，微 AF 组的最大 P 波持续时间（Pmax）（113±10.2 毫秒 vs. 98±10.4 毫秒；p<0.001）、最小 P 波持续时间（Pmin）（73.8±5.5 毫秒 vs. 70±6.3 毫秒；p<0.001）和 P 波弥散（PWD）（39.1±7.9 毫秒 vs. 28±7.6 毫秒；p<0.001）更长：结论：通过评估心电图、超声心动图和血清钠尿肽数据可预测患者的微AF。

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Natriuretic Peptide Concentrations and Echocardiography Findings in Patients with Micro-atrial Fibrillation.

Aim: Atrial fibrillation (AF) is a rhythm disorder characterized by very rapid and disorganized atrial-derived electrical activations with uncoordinated atrial contractions. Very short periods of AF-like activity (micro-AF) may be precursors of undetected, silent episodes of atrial fibrillation. Here, we examined the relationship between natriuretic peptide concentrations and echocardiography findings in patients with micro-AF.

Material and methods: The electrocardiograms (ECGs) of patients complaining of palpitations were recorded with a 24‑hour Holter monitor, and the patients were consecutively included in the study. Micro-AF was defined as sudden, irregular atrial tachycardia lasting less than 30 sec with episodes of ≥5 consecutive supraventricular depolarizations with the absolute absence of p-waves. After a G-power test, patients were consecutively included in the study: 45 patients in the micro-AF group and 45 patients in the control group. Laboratory parameters, ECG and echocardiographic findings of the two groups were compared.

Results: N-terminal pro B-type natriuretic peptide (Pro-BNP) and serum troponin T concentrations were higher in the micro-AF group, (375.5±63.6 pg / ml vs. 63.1±56.8 pg / ml, p<0.001; 13±11.4 ng / dl vs. 4.4±2.4 ng / dl, p<0.001 respectively.) Each 1 pg / ml increase in serum Pro-BNP increased the risk of micro-AF by 1.8 %. In the ROC analysis, the cut-off value of Pro-BNP for the diagnosis of micro-AF was 63.4 pg / ml, with a sensitivity of 91.1 % and a specificity of 73.3 %. Atrial electro-mechanical delay durations were significantly higher in the micro-AF group. To predict micro-AF, the inter-annulus plane electromechanical delay time (inter-annulus plane AEMD) had a cut-off value of 18.5 sec, with a sensitivity of 93.3 % and a specificity of 91.1 %. Left intra-annulus plane electro-mechanical delay time (intra-annulus AEMD LEFT) had a cut-off value of 11.5 sec with a 95.6 % sensitivity and 75.6 % specificity. In the ECG evaluation, maximum P wave duration (Pmax) (113±10.2 ms vs. 98±10.4 ms; p<0.001), minimum P wave duration (Pmin) (73.8±5.5 ms vs.70±6.3 ms; p<0.001) and P wave dispersion (PWD) (39.1±7.9 ms vs.28±7.6 ms; p<0.001) were longer in the micro-AF group.

Conclusions: Micro-AF in patients may be predicted by evaluating ECG, echocardiographic, and serum natriuretic peptide data.

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.