老年心力衰竭患者血压变异性与新发心房颤动的相关性

Correlation between blood pressure variability and new-onset atrial fibrillation in elderly patients with heart failure

目的探讨老年心力衰竭患者血压变异性与新发心房颤动的相关性。方法选取2019年1月至2021年6月山西医科大学第三医院收治的不伴心房颤动的老年心力衰竭患者180例,随访1年,期间新发心房颤动组32例,未新发心房颤动组148例。收集基线资料,行超声心动图检查、动态血压监测,采用logistic回归分析24 h收缩压变异性、舒张压变异性对心房颤动发生的影响。结果心房颤动组24 h收缩压变异性、24 h舒张压变异性、左心房前后径(LAD)大于非心房颤动组,24 h平均舒张压低于非心房颤动组(P<0.05);2组24 h平均收缩压、左心室舒张末期内径(LVEDD)差异无统计学意义(P>0.05)。24 h收缩压变异性与LAD、LVEDD呈正相关(r值分别为0.517、0.479,P<0.05)。logistic回归分析提示24 h收缩压变异性、24 h舒张压变异性是老年心力衰竭患者新发心房颤动的危险因素(OR_(1)=1.25,95%CI:1.051~1.522,P<0.05;OR_(2)=2.2,95%CI:1.491~3.413,P<0.05)。结论24 h血压变异性是老年心力衰竭患者新发心房颤动的危险因素。

Objective To explore the correlation between blood pressure variability and new-onset atrial fibrillation in elderly patients with heart failure.Methods We enrolled 180 elderly patients with heart failure who were treated in Third Hospital of Shanxi Medical University from January 2019 to June 2021.According to one-year follow-up,we divided these patients into atrial fibrillation group(32 cases)and non-AF group(148 cases).We collected baseline data including echocardiography and ambulatory blood pressure.We used Logistic regression to analyze the effects of 24-hour systolic blood pressure variability and diastolic blood pressure variability on the occurrence of atrial fibrillation.Results The 24-hour systolic blood pressure variability,24-hour diastolic blood pressure variability,and LAD(left Atrial Diameter)in the atrial fibrillation group were greater than those in the non-AF group,and the 24-hour average diastolic blood pressure was lower than that in the non-AF group(P<0.05).There was no difference in 24h mean systolic blood pressure and LVEDD(left ventricular end diastolic diameter)between the two groups(P>0.05).The 24-h systolic blood pressure variability was positively correlated with LAD and LVEDD(r=0.647 and 0.506,respectively,P<0.05).Logistic regression analysis found that 24-h systolic blood pressure variability was a risk factor for new-onset atrial fibrillation in elderly patients with heart failure(OR=2.271,95%CI:2.178-2.372,P<0.05).Conclusion 24-h blood pressure variability are risk factors for new-onset atrial fibrillation in elderly patients with heart failure.