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
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.
