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首页> 外文期刊>Heart rhythm: the official journal of the Heart Rhythm Society >Patients originally diagnosed with idiopathic atrial fibrillation more often suffer from insidious coronary artery disease compared to healthy sinus rhythm controls
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Patients originally diagnosed with idiopathic atrial fibrillation more often suffer from insidious coronary artery disease compared to healthy sinus rhythm controls

机译：与健康的窦性心律控制相比，最初被诊断为特发性房颤的患者更易患隐匿性冠状动脉疾病

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Background: Idiopathic atrial fibrillation (AF) refers to a clinically lacking cardiovascular or pulmonary disease generating the pathophysiologic substrate for the arrhythmia. However, because idiopathic AF is associated with an increased event rate, it could be a harbinger of as-yet undetected underlying heart disease. Objective: The purpose of this study was to determine the prevalence of coronary artery disease (CAD) in patients diagnosed with idiopathic paroxysmal AF. Methods: Of the 3243 patients who underwent cardiac computed tomographic angiography (CTA) in our center between January 2008 and March 2011, we identified a total of 115 consecutive idiopathic paroxysmal AF patients who underwent CTA before electrophysiologic ablation. Patients were compared with 275 age-, sex-, and PROCAM risk score-matched healthy controls in permanent sinus rhythm. All patients were free of hypertension, diabetes, congestive heart failure, previous known coronary artery and peripheral vascular disease, previous stroke, thyroid, pulmonary, and renal disease, and structural abnormalities on echocardiography. Results: Controls more often showed a family history of CAD (38% vs 15%, P <.001), had a higher prevalence of smoking (25% vs 14%, P =.021), higher fasting blood glucose levels (5.5 ± 0.7 mmol/L vs 5.4 ± 0.6 mmol/L, P =.025), and smaller atrial diameters (37 ± 4 mm vs 40 ± 5 mm, P <.001) compared to AF patients. Notwithstanding the above, idiopathic AF patients significantly more often suffered from subclinical CAD compared to controls (49% vs 34%, P =.008). Multivariable regression analysis revealed that beside (as expected) age and gender, a history of AF and left atrial diameter were significant predictors of underlying CAD. Conclusion: Half of patients originally diagnosed with idiopathic paroxysmal AF show concealed underlying CAD. The detection and treatment of CAD at an early stage could improve the prognosis of these patients.
机译：背景：特发性心房颤动（AF）是指临床上缺乏产生心律失常的病理生理底物的心血管或肺部疾病。但是，由于特发性房颤与事件发生率升高相关，因此它可能是尚未发现的潜在心脏病的先兆。目的：本研究旨在确定诊断为特发性阵发性AF的患者的冠状动脉疾病（CAD）患病率。方法：我们在2008年1月至2011年3月间对3243例接受了心脏计算机X线断层造影（CTA）的患者中，总共确定了115例连续的特发性阵发性AF患者在电生理消融前接受了CTA。将患者与275名年龄，性别和PROCAM风险评分匹配的健康对照组的永久性窦性心律进行比较。所有患者均无高血压，糖尿病，充血性心力衰竭，先前已知的冠状动脉和周围血管疾病，先前的中风，甲状腺，肺和肾脏疾病，以及超声心动图上的结构异常。结果：对照组更常显示有CAD家族史（38％vs 15％，P <.001），吸烟率较高（25％vs 14％，P = .021），空腹血糖水平较高（5.5）与AF患者相比，±0.7 mmol / L vs 5.4±0.6 mmol / L，P = .025），较小的心房直径（37±4 mm vs 40±5 mm，P <.001）。尽管如此，与对照组相比，特发性AF患者的亚临床CAD患病率明显更高（49％比34％，P = .008）。多变量回归分析显示，除了年龄和性别外（如预期的那样），AF史和左心房直径是潜在CAD的重要预测指标。结论：最初被诊断为特发性阵发性房颤的患者中有一半隐藏了潜在的CAD。早期检测和治疗CAD可改善这些患者的预后。

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