肥厚型心肌病发生房颤的危险因素分析

The Risk factors of Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy

目的探索肥厚型心肌病发生房颤的危险因素,为临床评估肥厚型心肌病发生房颤的风险提供思路。方法选择经超声心动图确诊的肥厚型心肌病患者218例,分为房颤组(30例)和非房颤组(188例),行单因素及多因素分析肥厚型心肌病发生房颤的危险因素。结果房颤组和非房颤组年龄(59.37±12岁比52±14.9岁,P=0.014)、左房内径(46.1±8.5mm比40.8±6.7mm,P<0.01)、肺动脉内径(25.56±4.34mm比24.26±3.84mm,P=0.015)、束支传导阻滞发生率(33.3%比14.8%,P=0.013)差异均有统计学意义(P<0.05)。多因素二元logistic回归分析提示年龄(OR=1.037,P=0.027)、左房内径(OR=1.115,P=0.001)、合并束支传导阻滞(OR=2.9,P=0.026)是肥厚型心肌病发生房颤的独立危险因素。结论年龄、左房内径、合并束支传导阻滞可作为肥厚型心肌病发生房颤的独立危险因素。

Objective To explore the risk factors of atrial fibrillation in patients with hypertrophic cardiomyopathy.Methods A total of 218 patients with hypertrophic cardiomyopathy diagnosed by echocardiography in our hospital were enrolled.Patients were divided into HCM with AF(30) and HCM without AF(188).Data were collected from hospital records.Results HCM patients with AF were older than HCM patients without AF(59.37±12 years versus 52±14.9years,P=0.002).LA diameter,Pulmonary artery diameter and the incidence of bundle branch block were significantly higher in HCM patients with AF than that of HCM patients without AF(46.1±8.5mm versus 40.8±6.7mm,P<0.01,25.56±4.34 versus 24.26±3.84mm,P=0.015 and 33.3% versus 14.8%,P=0.013,respectively).In a multivariable logistic regression analysis, when adjusting for age and LAD,The incidence of BBB remained an independent determinant of AF in HCM patients(OR=2.9,P=0.026).Conclusion Age,LAD,and bundle branch block are independent risk factors for atrial fibrillation in patients with hypertrophic cardiomyopathy.