代谢综合征对非左心室肥厚原发性高血压患者心房颤动的影响

目的 探讨代谢综合征(MS)对非左心室肥厚(LVH)原发性高血压(EH)患者心房颤动的影响.方法 入选972例EH患者,经心脏超声检查排除LVH,根据合并代谢综合征的情况分为EH+非MS组及EH+MS组,对两组的相关临床资料、超声心动图检查结果及心房颤动的发生情况进行分析比较.结果 (1)EH+MS组患者心房颤动发生率明显高于EH+非MS组(12.84%比6.93%,P<0.01).(2)EH+MS组左心房内径、左心室舒张末期内径、心室间隔厚度、左心室后壁厚度、左心室质量均高于EH+非MS组(P均<0.01),但左心室质量指数和左心射血分数两组之间差异无统计学意义.(3)Logistic回归分析显示原发性高血压患者发生心房颤动的危险与年龄、高血压病程、左心房增大、左心室扩大及合并MS明显相关(OR分别为1.683、1.308、2.262、3.848及1.853,P均<0.05),进一步回归分析显示MS中肥胖与心房颤动发生密切相关(OR为1.706,P=0.029).结论 MS与非LVH高血压患者发生心房颤动明显相关,控制体重可作为预防心房颤动的重要措施之一.

Association between metabolic syndrome and incidence of atrial fibrillation in essential hypertensive patients without left ventricular hypertrophy

Objective To investigate the association between metabolic syndrome (MS) and the incidence of atrial fibrillation (AF) in essential hypertensive (EH) patients without left ventricular hypertrophy. Methods A total of 972 EH without left ventricular hypertrophy were divided into EH + non MS group (n = 606) and EH + MS group (n = 366). Incidence of AF were compared between two groups. Results (1) Incidence of AF in EH + MS group was significantly higher than that in EH + non MS group(12.84% vs. 6.93%, P <0.01). (2) Left atrial diameter (LAD), left ventricular end-diastolic diameter(LVEDd), interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW) and left ventricular mass (LVM) were all significantly higher in EH + MS group than those in EH + non MS group(all P <0.01) while left ventricular mass index (LVMI) and ejection fraction (EF) were similar between two groups. (3) Logistic regression analysis showed age, hypertension duration, LAD, LVEDd and MS were significantly correlated with incidence of AF in EH patients (OR: 1.683,1.308, 2.262,3.848 and 1.853, P < 0.05) and obesity was the independent predictor for incidence of AF (OR: 1.706,P = 0.029). Conclusion MS was associated with increased incidence of AF in EH patients without left ventricular hypertrophy in this cohort.