目的:系统评价参松养心胶囊联合西药对阵发性房颤P波离散度的影响及安全性。方法:通过计算机检索Pubmed、Cochrane Library、Web of Science、中国知网、万方、维普数据库内自建库至2022年7月1日有关参松养心胶囊联合西药治疗阵发性房...目的:系统评价参松养心胶囊联合西药对阵发性房颤P波离散度的影响及安全性。方法:通过计算机检索Pubmed、Cochrane Library、Web of Science、中国知网、万方、维普数据库内自建库至2022年7月1日有关参松养心胶囊联合西药治疗阵发性房颤临床随机对照试验(randomized controlled trials,RCTs)。由2名研究员根据纳入及排除标准独立的对文献进行筛选,提取相关数据。采用RevMan5.4进行Meta分析。结果:共纳入11个临床随机对照试验,共1052例患者。Meta分析结果:实验组的P波离散度<对照组[MD=-7.12,95%CI(-9.21,-5.03),Z=6.69,P<0.00001];实验组的P波最大时限<对照组[MD=-7.88,95%CI(-10.12,-5.65),Z=6.91,P<0.00001];实验组的房颤发作次数<对照组[MD=-2.30,95%CI(-2.71,-1.85),Z=11.08,P<0.00001];实验组的左心房内径<对照组[MD=-2.59,95%CI(-3.83,-1.36),Z=4.11,P<0.00001];实验组的不良反应发生情况低于对照组。结论:参松养心胶囊联合西药可降低P波离散度,减少房颤复发,延缓左房内径扩大且具有良好的安全性。展开更多
Background： Current evidence links atrial fibrillation （AF） to the inflammation. Inflammatory indexes such as high-sensitive C-reactive protein （hs-CRP） have been related to the development and persistence of AF....Background： Current evidence links atrial fibrillation （AF） to the inflammation. Inflammatory indexes such as high-sensitive C-reactive protein （hs-CRP） have been related to the development and persistence of AF. However, the role of inflammation in the atrial electrophysiological remodeling indexed by P-wave dispersion （Pa） remains unclear. Methods： The study consisted of 71 patients with lone paroxysmal AF （AF group） and 71 age- and gender-matched controls of paroxysmal supraventricular tachycardia without history of AF （control group）. Electrocardiography, P hs-CRP, and other clinical characteristics were compared between the two groups. Results： There was no significant difference between the two groups regarding age, gender, hyperlipidemia, etc. Compared to controls, left atrial diameter （44 ± 7 vs 39 ± 7 mm）, Pd （49 ± 13 vs 26 ± 8 ms）, and hs-CRP （2.17 [1.46-2.89] vs 1.12 [0.74-1.41] rag/L） were increased （P 〈 0.05）, respectively. Linear regression identified hs-CRP as an independent correlation ofPd level both in the total population and the AF group （r = 0.464 and 0.313; P 〈 0.001, respectively）. Multiple logistic regression revealed hs-C RP as an independent determinant of AF （odds ratio [OR] =l 5.430, 95% confidence interval： 6.031-39.476： P 〈0.001）. Further adjusted tbr Pd, both Pd and hs-CRP were independent predictors for AF, but the OR for hs-CRP in predicting AF has been attenuated from 15.430 to 6.246. Conclusions： In lone AF, P and plasma hs-CRP concentration are inter-associated and related to AF. The interaction between hs-CRP and AF may be mediated by Pe, suggesting an important role of inflammation in the atrial electrophysiological remodeling predisposing to AF.展开更多
Background P-wave dispersion （PWD） is a useful predictor of paroxysmal atrial fibrillation （AF）. The effect of cardiac resynchronization therapy （CRT） on PWD and the prognostic implications of the improvement in...Background P-wave dispersion （PWD） is a useful predictor of paroxysmal atrial fibrillation （AF）. The effect of cardiac resynchronization therapy （CRT） on PWD and the prognostic implications of the improvement in PWD remain undefined. The aim of the study was to explore the clinical significance of the improvement of PWD after CRT. Methods Electrocardiographic studies were performed before and three months after CRT in 81 patients （57 men and 24 women; age （60.5±11.2） years） with standard CRT indication but no history of AF. A significant improvement of PWD （PWD responder） was defined as a relative decrease 〉20% from baseline PWD. The primary endpoints were new-onset AF detected by electrocardiogram （ECG） or CRT. Results After （30.6±7.5） months of follow-up, PWD responders （n=43） had a significantly lower incidence of AF than did PWD nonresponders, 12% vs. 29% （P 〈0.001）. In Cox proportional hazard analysis, PWD responders was the only predictor of lower risk of new-onset AF （HR 0.33, 95% confidence interval 0.12-0.96, P=0.033）. Conclusion Improvement of P-wave dispersion after CRT was associated with a lower incidence of AF, which may be related to the significant improvement in left ventricular systolic function and the reverse modeling of the left atrium.展开更多
Objective:To assess the sensitivity and the specifity of predicting idiopathic AF with P wave duration and P wave dispersion. Methods:The maximum P wave duration and P wave dispersion in 36 patients with idiopathic AF...Objective:To assess the sensitivity and the specifity of predicting idiopathic AF with P wave duration and P wave dispersion. Methods:The maximum P wave duration and P wave dispersion in 36 patients with idiopathic AF were measured and compared with those of sex - and age - matched healthy subjects. Results:The maximum P wave duration and P wave dispersion were higher in patients with idiopathic Af than in control group. The maximum P wave duration ＞ 110ms or P wave dispersion ＞40ms was used to differentiate patients from healthy subjects, the sensitivity and the specifity value were 88% vs 82% and 75 % vs 86%, respectively. When the above two parameters were integrated, the sensitivity was 76 %, the specifity 88 %. Conclusion: The maximum P.wave duration and P wave dispersion are simple and practical ECG indexes for idiopathic AF patients.展开更多
文摘目的探讨消融旁道后心房颤动(房颤)复发的预激综合征患者24 h动态心电图最大P波时限(Pmax)、P波离散度(Pd),并分析其对房颤复发的预测效能及临床意义。方法选取2019年5月~2022年5月北京中医医院顺义医院52例消融旁道后房颤复发的预激综合征患者为研究组,另选同期52例消融旁道后无房颤复发的预激综合征患者为对照组。比较两组临床资料、消融前后24 h动态心电图P波参数(Pmax、Pd)及变化值(△Pmax、△Pd)。Lasso-logistic回归模型分析房颤复发的相关因素。分析消融前、消融后2 d P波参数及变化值对房颤复发的预测价值。结果研究组年龄、病程、左心房内径、消融前房颤发作频率、消融前Pmax、Pd及消融后2 d Pmax、Pd均高于对照组[(50.26±8.13)岁比(41.31±7.65)岁、(5.29±1.18)年比(4.06±0.95)年、(42.39±4.12)mm比(32.68±3.97)mm、(5.79±1.26)次/月比(3.82±1.04)次/月、(121.57±11.68)ms比(104.95±10.24)ms、(55.36±8.73)ms比(41.70±7.21)ms、(112.39±10.75)ms比(92.44±9.30)ms、(50.18±7.69)ms比(34.07±6.42)ms],研究组LVEF、△Pmax、△Pd均低于对照组[(56.27±10.35)%比(65.14±11.42)%、(9.18±1.69)ms比(12.51±1.81)ms、(5.18±1.22)ms比(7.63±1.43)ms,P<0.05]。年龄、LVEF、消融前房颤发作频率、消融前后Pmax、Pd、△Pmax、△Pd为房颤复发的影响因素(P<0.05);△Pmax、△Pd联合预测房颤复发的AUC为0.931,大于消融前后Pmax、Pd联合预测的AUC 0.853、0.876(P<0.05);基于影响因素构建预测模型,含P波参数变化值预测房颤复发的AUC为0.952,大于不含P波参数变化值预测的AUC 0.875(P<0.05)。结论24 h动态心电图Pmax、Pd变化值对预激综合征患者消融旁道后房颤复发具有一定预测价值。
文摘Background： Current evidence links atrial fibrillation （AF） to the inflammation. Inflammatory indexes such as high-sensitive C-reactive protein （hs-CRP） have been related to the development and persistence of AF. However, the role of inflammation in the atrial electrophysiological remodeling indexed by P-wave dispersion （Pa） remains unclear. Methods： The study consisted of 71 patients with lone paroxysmal AF （AF group） and 71 age- and gender-matched controls of paroxysmal supraventricular tachycardia without history of AF （control group）. Electrocardiography, P hs-CRP, and other clinical characteristics were compared between the two groups. Results： There was no significant difference between the two groups regarding age, gender, hyperlipidemia, etc. Compared to controls, left atrial diameter （44 ± 7 vs 39 ± 7 mm）, Pd （49 ± 13 vs 26 ± 8 ms）, and hs-CRP （2.17 [1.46-2.89] vs 1.12 [0.74-1.41] rag/L） were increased （P 〈 0.05）, respectively. Linear regression identified hs-CRP as an independent correlation ofPd level both in the total population and the AF group （r = 0.464 and 0.313; P 〈 0.001, respectively）. Multiple logistic regression revealed hs-C RP as an independent determinant of AF （odds ratio [OR] =l 5.430, 95% confidence interval： 6.031-39.476： P 〈0.001）. Further adjusted tbr Pd, both Pd and hs-CRP were independent predictors for AF, but the OR for hs-CRP in predicting AF has been attenuated from 15.430 to 6.246. Conclusions： In lone AF, P and plasma hs-CRP concentration are inter-associated and related to AF. The interaction between hs-CRP and AF may be mediated by Pe, suggesting an important role of inflammation in the atrial electrophysiological remodeling predisposing to AF.
文摘Background P-wave dispersion （PWD） is a useful predictor of paroxysmal atrial fibrillation （AF）. The effect of cardiac resynchronization therapy （CRT） on PWD and the prognostic implications of the improvement in PWD remain undefined. The aim of the study was to explore the clinical significance of the improvement of PWD after CRT. Methods Electrocardiographic studies were performed before and three months after CRT in 81 patients （57 men and 24 women; age （60.5±11.2） years） with standard CRT indication but no history of AF. A significant improvement of PWD （PWD responder） was defined as a relative decrease 〉20% from baseline PWD. The primary endpoints were new-onset AF detected by electrocardiogram （ECG） or CRT. Results After （30.6±7.5） months of follow-up, PWD responders （n=43） had a significantly lower incidence of AF than did PWD nonresponders, 12% vs. 29% （P 〈0.001）. In Cox proportional hazard analysis, PWD responders was the only predictor of lower risk of new-onset AF （HR 0.33, 95% confidence interval 0.12-0.96, P=0.033）. Conclusion Improvement of P-wave dispersion after CRT was associated with a lower incidence of AF, which may be related to the significant improvement in left ventricular systolic function and the reverse modeling of the left atrium.
文摘Objective:To assess the sensitivity and the specifity of predicting idiopathic AF with P wave duration and P wave dispersion. Methods:The maximum P wave duration and P wave dispersion in 36 patients with idiopathic AF were measured and compared with those of sex - and age - matched healthy subjects. Results:The maximum P wave duration and P wave dispersion were higher in patients with idiopathic Af than in control group. The maximum P wave duration ＞ 110ms or P wave dispersion ＞40ms was used to differentiate patients from healthy subjects, the sensitivity and the specifity value were 88% vs 82% and 75 % vs 86%, respectively. When the above two parameters were integrated, the sensitivity was 76 %, the specifity 88 %. Conclusion: The maximum P.wave duration and P wave dispersion are simple and practical ECG indexes for idiopathic AF patients.
