长期持续性心房颤动患者静息心率控制与脉搏波传导速度的关系
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摘要
目的研究长期持续性心房颤动患者静息心率控制与脉搏波传导速度(PWV)的关系。方法序贯收集于2011年12月-2012年3月在四川大学华西医院心脏内科门诊就诊的长期持续性心房颤动患者84例,将人群按静息心率是否低于80次/min,分为标准组(心率<80次/min)和对照组(心率≥80次/min),采用Pearson相关及多元线性回归分析方法,研究静息心率控制与PWV的关系。结果①标准组人群的PWV显著低于对照组,而饮酒率显著高于对照组,差异皆有统计学意义(P<0.05)。②Pearson相关分析显示静息心率与PWV存在线性相关关系(r=0.355,P=0.001);多元线性回归分析显示,在调整了年龄、性别、BMI、收缩压、舒张压、吸烟、饮酒、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白等混杂因素影响后,心率与PWV仍独立相关。结论长期持续性心房颤动患者的静息心率控制不良与PWV升高关系密切。
Objective To investigate the relationship between resting heart rate controlling and pulse wave velocity PWV) in patients with long-standing persistent atrial fibrillation(AF).Methods We sequentially enrolled outpatients diagnosed to have long-standing persistent atrial fibrillation in the Cardiology Department of West China Hospital,Sichuan University from December 2011 to March 2012,and divided these patients into standard group(heart rate < 80 beats per minute) and control group(heart rate ≥ 80 beats per minute) based on the level of heart rate.We analyzed the relationship between resting heart rate and PWV by using Pearson correlation analysis and multiple linear regression analysis. Results PWV in the standard group was significant lower than that in the control group,while the alcohol use rate was significant higher in the standard group(P < 0.05).Pearson relationship analysis showed a linear correlation between resting hear rate and PWV(r=0.355,P=0.001).After adjusting for age,sex,body mass index,systdic blood pressure, diastolic blood presure,smoking,drinking,the fasting blood glucose,glycerin trilaurate,total cholesterol,high density lipoprotein and low density lipoprotein,and the heart rate also had independent correlation with PWV in patients with long-standing persistent AF.Conclusion The uncontrolled resting heart rate has close relationship with PWV elevating in patients with long-standing persistent AF.
Objective To investigate the relationship between resting heart rate controlling and pulse wave velocity PWV) in patients with long-standing persistent atrial fibrillation(AF).Methods We sequentially enrolled outpatients diagnosed to have long-standing persistent atrial fibrillation in the Cardiology Department of West China Hospital,Sichuan University from December 2011 to March 2012,and divided these patients into standard group(heart rate < 80 beats per minute) and control group(heart rate ≥ 80 beats per minute) based on the level of heart rate.We analyzed the relationship between resting heart rate and PWV by using Pearson correlation analysis and multiple linear regression analysis. Results PWV in the standard group was significant lower than that in the control group,while the alcohol use rate was significant higher in the standard group(P < 0.05).Pearson relationship analysis showed a linear correlation between resting hear rate and PWV(r=0.355,P=0.001).After adjusting for age,sex,body mass index,systdic blood pressure, diastolic blood presure,smoking,drinking,the fasting blood glucose,glycerin trilaurate,total cholesterol,high density lipoprotein and low density lipoprotein,and the heart rate also had independent correlation with PWV in patients with long-standing persistent AF.Conclusion The uncontrolled resting heart rate has close relationship with PWV elevating in patients with long-standing persistent AF.
引文
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[11]O’Rourke MF,Hashimoto J.Mechanical factors in arterial aging:a clinical perspective[J].JACC,2007,50(1):1-13.
[12]Virmani R,Avolio AP,Mergner WJ,et al.Effect of aging on aortic morphology in populations with high and low prevalence of hypertension and atherosclerosis[J].Am J Pathol,1991,139(5):1119-1129.
[13]da Luz PL,Coimbra SR.Wine,Alcohol and atherosclerosis:clinical evidences and mechanisms[J].Braz J Med Biol Res,2004,37(9):1275-1295.
[14]Klatsky AL,Friedman GD,Armstrong MA,et al.Wine,liquor,beer,and mortality[J].Am J Epidemiol,2003,158(6):585-595.
[15]Opie LH,Lecour S.The red wine hypothesis:from concepts to protective signalling molecules[J].Eur Heart J,2007,28(14):1683-1693.
[2]Fuster V,Rydén LE,Cannom DS,et al.ACC/AHA/ESC 2006Guidelines for the Management of Patients with Atrial Fibrillation:a report of the American College of Cardiology/American HeartAssociation Task Force on Practice Guidelines and the EuropeanSociety of Cardiology Committee for Practice Guidelines(WritingCommittee to Revise the 2001 Guidelines for the Management ofPatients With Atrial Fibrillation):developed in collaboration withthe European Heart Rhythm Association and the Heart RhythmSociety[J].Circulation,2006,114(7):257-354.
[3]van Gelder IG,Groenveld HF,Crijns HJ,et al.Lenient versus strictrate control in patients with atrial fibrillation[J].N Engl J Med,2010,362(15):1363-1373.
[4]O’Rourke MF,Gallagher DE.Pulse wave analysis[J].J Hypertens Suppl,1996,14(5):S147-S157.
[5]European Heart Rhythm Association,European Association for Cardio-Thoracic Surgery,Camm AJ,et al.Guidelines for the management of atrial fibrillation:the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology(ESC)[J].Eur Heart J,2010,31(19):2369-2429.
[6]Wann LS,Curtis AB,January CT,et al.2011ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation(updating the2006guideline):a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J].Heart Rhythm,2011,8(1):157-176.
[7]赵月香,王玉堂.心房颤动心室率控制的研究进展[J].军医进修学院学报,2012,33(7):796-799.
[8]Cucherat M.Quantitative relationship between resting heart rate reduction and magnitude of clinical benefits in post-myocardial infarction:a meta-regression of randomized clinical trials[J].Eur Heart J,2007,28(24):3012-3019.
[9]褚稳稳,吴秀萍.动脉僵硬度研究进展[J].中华临床医师杂志(电子版),2012,6(1):168-170.
[10]Aronow WS,Fleg JL,Pepine CJ,et al.ACCF/AHA2011expert consensus document on hypertension in the elderly:a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus documents developed in collaboration with the American Academy of Neurology,American Geriatrics Society,American Society for Preventive Cardiology,American Society of Hypertension,American Society of Nephrology,Association of Black Cardiologists,and European Society of Hypertension[J].J Am Coll Cardiol,2011,57(20):2037-2114.
[11]O’Rourke MF,Hashimoto J.Mechanical factors in arterial aging:a clinical perspective[J].JACC,2007,50(1):1-13.
[12]Virmani R,Avolio AP,Mergner WJ,et al.Effect of aging on aortic morphology in populations with high and low prevalence of hypertension and atherosclerosis[J].Am J Pathol,1991,139(5):1119-1129.
[13]da Luz PL,Coimbra SR.Wine,Alcohol and atherosclerosis:clinical evidences and mechanisms[J].Braz J Med Biol Res,2004,37(9):1275-1295.
[14]Klatsky AL,Friedman GD,Armstrong MA,et al.Wine,liquor,beer,and mortality[J].Am J Epidemiol,2003,158(6):585-595.
[15]Opie LH,Lecour S.The red wine hypothesis:from concepts to protective signalling molecules[J].Eur Heart J,2007,28(14):1683-1693.