肥厚型梗阻性心肌病药物治疗患者新发心房颤动危险因素分析

The risk factors of new-onset atrial fibrillation in hypertrophic obstructive cardiomyopathy patients treated by drugs

目的探索接受药物治疗的肥厚型梗阻性心肌病(HOCM)患者新发心房颤动(AF)率及危险因素。方法对2000年1月至2014年12月入选的无AF病史HOCM患者进行随访及相关资料收集,用SPSS19统计学软件分析随访结果。结果 147例HOCM患者入选,随访(4.5±3.3)年新发AF 27例(18.4%);AF组左房内径(LAD)[(49.3±4.0)mm vs(37.9±5.7)mm]明显大(P=0.000);根据LAD分成两组,分别为LAD>45mm组(23例,15.6%)和LAD≤45mm组(124例,84.4%),Kaplan-Meier分析结果显示LAD>45 mm组累积新发AF率高于对照组(Log-Rankχ~2=28.0,P=0.000)。结论长期随访中,接受药物治疗的HOCM患者新发AF率较高,LAD增大是其新发AF的危险因素。

Objective To determine the risk of new-onset atrial fibrillation （AF） in the patients with hypertrophic obstructive cardiomyopathy （HOCM） who accepted drugs only. Methods A total 147 HOCM patients without AF history were enrolled. After mean follow-up of （4.5±3.3） years , the results were analyzed by SPSS 19. Results In the 147 HOCM patients, there were 27 patients （18.4%） developed new-onset AF during the follow-up. The patients in group of new-onset AF had a larger left atrial diameter （LAD） [（49.3±4.0）mm vs（37.9±5.7） mm, P =0.0001 compared with the patients without AF. Then , the HOCM patients was divided into two groups（ LAD〉45 mm Group and LAD≤45 mm Group） according to LAD. The Kaplan-Meier analysis showed that the new-onset AF rate in LAD〉 45 mm group was higher than that in control group （Log-Rank x2 = 28.0, P =0.000）. Conclusion During long term follow-up, the rate of new-onset AF in HOCM patients only treated by drugs was significantly higher than that in the general population; The LAD was one risk factor of the new-onset AF.