{"title":"左心房大小和左心房容积指数作为心房高发生率发作的预测指标。","authors":"Phuuwadith Wattanachayakul, Thitiphan Srikulmontri, Narathorn Kulthamrongsri, Kevin Bryan Lo, Jakrin Kewcharoen, Sumeet Mainigi","doi":"10.1111/pace.15197","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Recent studies have shown that atrial high-rate episodes (AHREs) are associated with adverse cardiovascular outcomes, including an increased risk of stroke, cardiovascular mortality, and future atrial fibrillation. Despite efforts to identify predictors for AHRE, the relationship between left atrial morphology and AHRE remains unclear.</p><p><strong>Methods: </strong>We systematically reviewed MEDLINE and EMBASE from inception to May 2024 to assess the association between left atrial morphology, measured as left atrial diameter (mm) and left atrial volume index (LAVI, mL/m<sup>2</sup>) via transthoracic echocardiography, and the occurrence of AHRE in patients without a prior history of atrial fibrillation at device implantation. Means and standard deviations of LAD and LAVI were extracted to calculate pooled mean differences using the generic inverse variance method.</p><p><strong>Results: </strong>A total of 18 cohort studies were included in the meta-analysis. The results showed that patients with AHRE had significantly higher left atrial diameter and LAVI compared to those without AHRE. The pooled mean difference for left atrial diameter was 2.19 mm (95% CI: 1.11-3.28; I<sup>2</sup> = 80%, p < 0.001), while for LAVI, it was 4.88 mL/m<sup>2</sup> (95% CI: 2.55-7.21; I<sup>2</sup> = 55%, p < 0.001).</p><p><strong>Conclusions: </strong>Our study demonstrated that patients with AHRE had greater left atrial diameter and LAVI than those without AHRE. Further research is needed to clarify the underlying mechanism.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"569-577"},"PeriodicalIF":1.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Left Atrial Size and Left Atrial Volume Index as Predictors of Atrial High-Rate Episodes.\",\"authors\":\"Phuuwadith Wattanachayakul, Thitiphan Srikulmontri, Narathorn Kulthamrongsri, Kevin Bryan Lo, Jakrin Kewcharoen, Sumeet Mainigi\",\"doi\":\"10.1111/pace.15197\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Recent studies have shown that atrial high-rate episodes (AHREs) are associated with adverse cardiovascular outcomes, including an increased risk of stroke, cardiovascular mortality, and future atrial fibrillation. Despite efforts to identify predictors for AHRE, the relationship between left atrial morphology and AHRE remains unclear.</p><p><strong>Methods: </strong>We systematically reviewed MEDLINE and EMBASE from inception to May 2024 to assess the association between left atrial morphology, measured as left atrial diameter (mm) and left atrial volume index (LAVI, mL/m<sup>2</sup>) via transthoracic echocardiography, and the occurrence of AHRE in patients without a prior history of atrial fibrillation at device implantation. Means and standard deviations of LAD and LAVI were extracted to calculate pooled mean differences using the generic inverse variance method.</p><p><strong>Results: </strong>A total of 18 cohort studies were included in the meta-analysis. The results showed that patients with AHRE had significantly higher left atrial diameter and LAVI compared to those without AHRE. The pooled mean difference for left atrial diameter was 2.19 mm (95% CI: 1.11-3.28; I<sup>2</sup> = 80%, p < 0.001), while for LAVI, it was 4.88 mL/m<sup>2</sup> (95% CI: 2.55-7.21; I<sup>2</sup> = 55%, p < 0.001).</p><p><strong>Conclusions: </strong>Our study demonstrated that patients with AHRE had greater left atrial diameter and LAVI than those without AHRE. Further research is needed to clarify the underlying mechanism.</p>\",\"PeriodicalId\":54653,\"journal\":{\"name\":\"Pace-Pacing and Clinical Electrophysiology\",\"volume\":\" \",\"pages\":\"569-577\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pace-Pacing and Clinical Electrophysiology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1111/pace.15197\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pace-Pacing and Clinical Electrophysiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.15197","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：最近的研究表明，心房高发生率发作（AHREs）与不良心血管结局相关，包括卒中、心血管死亡和未来心房颤动的风险增加。尽管努力确定AHRE的预测因素，但左房形态学与AHRE之间的关系仍不清楚。方法：我们系统地回顾MEDLINE和EMBASE从成立到2024年5月，通过经胸超声心动图评估左房形态学（左房直径（mm）和左房容积指数（LAVI, mL/m2））与器械植入时无房颤病史的患者发生AHRE之间的关系。提取LAD和LAVI的均值和标准差，采用通用反方差法计算合并均值差。结果：荟萃分析共纳入18项队列研究。结果显示，有AHRE的患者左房内径和LAVI明显高于无AHRE的患者。左房内径的合并平均差为2.19 mm (95% CI: 1.11-3.28；I2 = 80%, p 2 (95% CI: 2.55 ~ 7.21；结论：我们的研究表明，AHRE患者的左房内径和LAVI大于非AHRE患者。需要进一步的研究来阐明其潜在的机制。
Left Atrial Size and Left Atrial Volume Index as Predictors of Atrial High-Rate Episodes.
Background: Recent studies have shown that atrial high-rate episodes (AHREs) are associated with adverse cardiovascular outcomes, including an increased risk of stroke, cardiovascular mortality, and future atrial fibrillation. Despite efforts to identify predictors for AHRE, the relationship between left atrial morphology and AHRE remains unclear.
Methods: We systematically reviewed MEDLINE and EMBASE from inception to May 2024 to assess the association between left atrial morphology, measured as left atrial diameter (mm) and left atrial volume index (LAVI, mL/m2) via transthoracic echocardiography, and the occurrence of AHRE in patients without a prior history of atrial fibrillation at device implantation. Means and standard deviations of LAD and LAVI were extracted to calculate pooled mean differences using the generic inverse variance method.
Results: A total of 18 cohort studies were included in the meta-analysis. The results showed that patients with AHRE had significantly higher left atrial diameter and LAVI compared to those without AHRE. The pooled mean difference for left atrial diameter was 2.19 mm (95% CI: 1.11-3.28; I2 = 80%, p < 0.001), while for LAVI, it was 4.88 mL/m2 (95% CI: 2.55-7.21; I2 = 55%, p < 0.001).
Conclusions: Our study demonstrated that patients with AHRE had greater left atrial diameter and LAVI than those without AHRE. Further research is needed to clarify the underlying mechanism.
期刊介绍：
Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
