摘要
目的 通过CHARGE-AF模型评估外科减重术对肥胖症患者心房颤动(房颤)发生风险的影响.方法 纳入2016年8月至2020年5月期间入院拟行袖状胃切除术(LSG术)的肥胖症患者,收集并记录受试者行LSG术前及术后的相关病史、体格检查和心电图结果,根据CHARGE-AF模型和CHARGE-AF增强模型公式计算房颤发生风险.结果 研究共纳入67例受试者,平均随访时间为11.11±5.51个月.LSG术后受试者的体重、收缩压、舒张压、降压药物服用率、糖尿病患病率、心肌肥厚发生率、PR间期＜120 ms发生率均显著性降低.而抽烟率、心力衰竭(心衰)患病率、心肌梗死(心梗)患病率、PR间期＞199 ms未发生显著性变化.根据CHARGE-AF模型公式计算,受试者房颤发生风险呈降低趋势,由(0.11±0.10)%降至(0.08±0.08)%,(P=0.07).根据CHARGE-AF增强模型计算,受试者房颤发生风险显著降低,由(0.12±0.12)%降至(0.08±0.08)%,(P＜0.05).将体重变量单因素纳入模型计算出受试者房颤发生风险显著降低(P＜0.001).结论 肥胖症患者在减重术后房颤发生的可能危险因素(如体重、血压、心室肥厚等)均得到显著改善,房颤的发生风险显著降低.
Abstract
Objective To evaluate the impact of bariatric surgery on the risk of atrial fibrillation(AF)in obese patients using the CHARGE-AF model.Methods Obese patients who underwent laparoscopic sleeve gastrectomy(LSG)between August 2016 and May 2020 were included in this study.The relevant medical history,physical examination,and electrocardiogram results before and after LSG were collected and recorded,and the risk of AF was calculated using the CHARGE-AF model and CHARGE-AF enhanced model formula.Results A total of 67 participants were included in the study,with a mean follow-up time of 11.11±5.51 months.After LSG,there was a significant decrease in weight,systolic blood pressure,diastolic blood pressure,the rate of antihypertensive drug use,diabetes prevalence,myocardial hypertrophy incidence,and PR interval<120 ms incidence.However,there was no significant change in smoking rate,heart failure incidence,myocardial infarction incidence,or PR interval>199 ms incidence.According to the CHARGE-AF model formula,there was a decreasing trend in AF risk among participants[(0.11±0.10)%to(0.08±0.08)%,(P=0.07)].According to the CHARGE-AF enhanced model,the risk of AF was significantly reduced[(0.12±0.12)%to(0.08±0.08)%,(P<0.05)].When weight was included as a single-factor variable in the model,the risk of AF in participants was significantly reduced(P<0.001).Conclusion The possible risk factors for AF in obese patients,such as weight,blood pressure,and ventricular hypertrophy,were significantly improved after weight loss surgery,and the risk of AF was significantly reduced.
基金项目
上海市卫生系统重要疾病联合攻关项目(2013ZYJB0902)
NETL
NSTL
维普
万方数据