摘要
目的 探讨肺动脉高压(PAH)与高龄射血分数保留型心力衰竭(HFpEF)患者发生心房颤动(简称房颤)的相关性.方法 根据有无房颤病史,将435例75-100岁HFpEF患者分为房颤组197例和非房颤组238例.比较两组患者的基线资料;采用Pearson相关分析评估高龄HFpEF患者各指标与发生房颤的相关性;采用单因素和多因素logistic回归分析评估高龄HFpEF患者发生房颤的危险因素;采用受试者工作特征(ROC)曲线分析危险因素对高龄HFpEF发生房颤的预测价值.结果 房颤组有冠心病病史、PAH病史患者比例及血肌酐(SCr)、胱抑素C、左心房左右径、左心房前后径、右心房左右径、右心房上下径、肺动脉压均高于非房颤组,低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、左心室射血分数均低于非房颤组(P＜0.05).Pearson相关分析结果显示,高龄HFpEF患者SCr、胱抑素C、左心房左右径、左心房前后径、右心房左右径、右心房上下径、肺动脉压、冠心病病史、PAH病史与发生房颤均呈正相关,LDL-C、TG、左心室射血分数与发生房颤均呈负相关(P＜0.05).单因素logistic回归分析结果显示,胱抑素C、左心房左右径、左心房前后径、右心房左右径、右心房上下径、肺动脉压、PAH病史是高龄HFpEF患者发生房颤的危险因素,LDL-C、左心室射血分数、冠心病病史是其保护因素(P＜0.05).多因素logistic回归分析结果显示,左心房左右径、右心房上下径、肺动脉压、冠心病病史、PAH病史是高龄HFpEF患者发生房颤的危险因素(P＜0.05)o ROC曲线分析结果显示,左心房左右径、右心房上下径、肺动脉压、冠心病病史、PAH病史对高龄HFpEF患者发生房颤均有一定预测价值.结论PAH与高龄HFpEF患者发生房颤相关,且是其危险因素.
Abstract
Objective To explore the correlation between pulmonary hypertension(PAH)and atrial fibrillation(AF)in elderly patients with ejection fraction preserved heart failure(HFpEF).Methods According to with AF history or not,435 patients with HFpEF who aged 75-100 years old were divided into AF group(197 cases)and non-AF group(238 cases).Baseline data between two groups were compared.Pearson correlation analysis was used to evaluate correlation between various indexes and AF in elderly patients with HFpEF.Univariate and multivariate logistic regression analysis were used to evaluate risk factors for AF in elderly patients with HFpEF.Receiver operating characteristic(ROC)curve was used to analyze predictive value of risk factors for AF in elderly patients with HFpEF.Results Proportion of patients with coronary heart disease history and PAH history,serum creatinine(SCr),cystatin C,left and right diameter of left atrium,anterior and posterior diameter of left atrium,left and right diameter of right atrium,upper and lower diameter of right atrium,pulmonary artery pressure in AF group were higher than those in non-AF group,low density lipoprotein cholesterol(LDL-C),triglycerides(TG)and left ventricular ejection fraction were lower than those in non-AF group(P＜0.05).Pearson correlation analysis showed that SCr,cystatin C,left and right diameter of left atrium,anterior and posterior diameter of left atrium,left and right diameter of right atrium,upper and lower diameter of right atrium,pulmonary artery pressure,coronary heart disease history and PAH history were positively correlated with AF in elderly patients with HFpEF,LDL-C,TG,left ventricular ejection fraction were negatively correlated with AF in elderly patients with HFpEF(P＜0.05).Univariate logistic regression analysis showed that cystatin C,left and right diameter of left atrium,anterior and posterior diameter of left atrium,left and right diameter of right atrium,upper and lower diameter of right atrium,pulmonary artery pressure,PAH history were risk factors for AF in elderly patients with HFpEF,LDL-C,left ventricular ejection fraction and coronary heart disease history were its protective factors(P＜0.05).Multivariate logistic regression analysis showed that left and right diameter of left atrium,upper and lower diameter of right atrium,pulmonary artery pressure,coronary heart disease history and PAH history were risk factors for AF in elderly patients with HFpEF(P＜0.05).ROC curve analysis show that left and right diameter of left atrium,upper and lower diameter of right atrium,pulmonary artery pressure,coronary heart disease history and PAH history had certain predictive value for AF in elderly patients with HFpEF.Conclusion PAH is correlated with AF in elderly patients with HFpEF,and is a risk factor for it.
基金项目
广州市科技局基础研究计划市重点实验室建设项目(2023A03J0170)
中国人民解放军南部战区总医院育才基金资助项目(2022NZC001)
维普
万方数据