High Premature Atrial Complex Loads Indicate a High Central Aortic Pressure Index in Young Low-Risk Patients

在年輕低危險族群中，高的早發性心房收縮數意味著有高的大動脈硬度指數

陳儒逸(Ju-Yi Chen) ； 蔡惟全(Wei-Chuan Tsai) ； 李政翰(Cheng-Han Lee) ； 李貽恆(Yi-Heng Li) ； 蔡良敏(Liang-Miin Tsai) ； 陳志鴻(Jyh-Hong Chen) ； 林立人(Li-Jen Lin)

《Acta Cardiologica Sinica》 23卷3期 (2007/09) Pp. 143-149

摘要

背景　本研究目的在檢驗在年輕低危險族群中，早發性心房收縮數與大動脈硬度指數之關係。
方法員本計畫包括200位病患因為心悸而接受二十四小時心電圖檢查並同時測量兩個大動脈硬度指標－動脈反射波增強(Augmentation: AG)及動脈反射波增強指數(Augmentation index: AIx)。我們同時紀錄病患之血管粥狀硬化危險因子。少於兩個危險因子的為低危險族群。
結果　在本研究的200位病患中，有23位病患(12%)有高的早發性心房收縮數。他們有比較高的年紀(P=0.037)、動脈反射波增強中(P=0.02)、及動脈反射波增強指數中(P=0.008)。而性別、危險因子、及藥物史並無差異。在多變數分析中，高的早發性心房收縮數(P=0.036)是與動脈反射波增強指數相關之獨立因子。在本研究的200位病患中，有134位屬於低危險族群。其中19位病患(14%)有高的早發性心房收縮數。他們有比較高的年紀(P=0.042)、動脈反射波增強(P=0.012)、及動脈反射波增強指數(P=0.002)。在多變數分析中，高的早發性心房收縮數中(P=0.021)是與動脈反射波增強指數相關之獨立因子。
結論　我們認為在年輕低危險族群中，高的早發性心房收縮數與高的大動脈硬度指數具有有意義之相關。高的早發性心房收縮數可能是大動脈硬度的預測因子。

關鍵字

動脈反射波增強指數 ； 動脈硬度 ； 心房性心搏過速心律不整

並列摘要

Objectives: To elucidate the relation between premature atrial complex (PAC) loads and aortic stiffness in the low-risk young population.
Methods: We enrolled 200 consecutive patients (＜50 years old; 95 men; mean age, 36±10 years) who received a 24-h ambulatory electrocardiography (ECG) examination for palpitation. Aortic stiffness and two aortic pressure indices-augmentation (AG) and the augmentation index (AIx)-were measured, and atherosclerosis risk factors were evaluated. Patients with ＜ 2 risk factors were defined as the low-risk group.
Results: Twenty-three patients (12%) had high PAC loads. Age (p=0.037), AG (p=0.022), and AIx (p=0.008) were significantly higher in these patients. Gender, risk factors, and drug history were not associated with high PAC loads. A multivariate analysis showed high PAC loads (p=0.036, OR 1.09, 95% C.I. 1.01~1.18) was an independent factor associated with AIx.
In the low-risk group, 19(14%) patients had high PAC loads. Age (p=0.042), AG (p=0.012), and AIx (p=0.002) were significantly higher in patients with high PAC loads. A multivariate analysis showed high PAC loads (p=0.021, OR 1.23, 95% C.I. 1.03-1.41) was an independent factor associated with AIx in low-risk patients.
Conclusion: High PAC loads were significantly associated with increased central aortic pressure indices in young subjects, especially in the low-risk subgroup. High PAC loads might be a surrogate marker of central aortic stiffness in a low-risk group.

並列關鍵字

Augmentation index ； Arterial stiffness ； Atrial tachyarrhythmias