Background

Arterial stiffness has emerged as a strong predictor of cardiovascular disease, end-organ damage and all-cause mortality. Although increased arterial stiffness has been described as a predictor of atrial fibrillation, the relationship between arterial stiffness and atrial fibrillation is uncertain.

Aim

We assessed arterial stiffness in patients with atrial fibrillation compared with that in a control group.

Methods

We enrolled 151 patients with atrial fibrillation who underwent pulmonary vein isolation (mean age 71.1 ± 9.8 years) and 54 control patients with similar cardiovascular risk profiles and sinus rhythm, matched for age (mean age 68.6 ± 15.7 years) and sex. Aortic distensibility as a measure of arterial stiffness was assessed by transoesophageal echocardiography. Patients with atrial fibrillation were followed over a median of 21 (15 to 31) months.

Results

Compared with control patients, patients with atrial fibrillation had significantly lower aortic distensibility (1.8 ± 1.1 vs. 2.1 ± 1.1 10⁻³ mmHg⁻¹; P = 0.02). Age (hazard ratio 0.67, 95% confidence interval 0.003 to 0.03; P = 0.02) and pulse pressure (hazard ratio –1.35, 95% confidence interval –0.07 to –0.03; P < 0.0001) were the strongest predictors of decreased aortic distensibility in the study cohort. This effect was independent of the type of atrial fibrillation (paroxysmal/persistent). During follow-up, decreased aortic distensibility was a predictor of cardiovascular and all-cause hospitalizations, as well as recurrences of atrial fibrillation, with a higher incidence rate of events in patients in the lowest aortic distensibility quartile (P = 0.001).

Conclusions

Aortic distensibility was significantly reduced in patients with atrial fibrillation, with age and pulse pressure showing the strongest correlation, independent of the type of atrial fibrillation. Additionally, decreased aortic distensibility was associated with cardiovascular and all-cause hospitalizations, as well as recurrences of atrial fibrillation, which showed a quartile-dependent occurrence.

中文翻译：

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房颤患者动脉僵硬度的决定因素

背景

动脉僵硬已成为心血管疾病、终末器官损伤和全因死亡率的有力预测指标。尽管增加的动脉僵硬度已被描述为心房颤动的预测因子，但动脉僵硬度与心房颤动之间的关系尚不确定。

目的

我们评估了房颤患者与对照组的动脉僵硬度。

方法

我们招募了 151 名接受肺静脉隔离的房颤患者（平均年龄 71.1  ±  9.8 岁）和 54 名具有相似心血管风险特征和窦性心律的对照患者，年龄（平均年龄 68.6  ±  15.7 岁）和性别匹配。通过经食道超声心动图评估主动脉扩张性作为动脉僵硬度的衡量标准。房颤患者的中位随访时间为 21（15 至 31）个月。

结果

与对照患者相比，房颤患者的主动脉扩张性显着降低（1.8  ±  1.1 vs. 2.1  ±  1.1 10 ^-3  mmHg ^-1；P  =  0.02）。年龄（风险比 0.67，95% 置信区间 0.003 至 0.03；P  =  0.02）和脉压（风险比 –1.35，95% 置信区间 –0.07 至 –0.03；P  < 0.0001) 是研究队列中主动脉扩张性降低的最强预测因子。这种影响与心房颤动的类型（阵发性/持续性）无关。在随访期间，主动脉扩张性降低是心血管和全因住院以及房颤复发的预测因素，主动脉扩张性最低四分位数患者的事件发生率较高（P  =  0.001）。

结论

房颤患者的主动脉扩张性显着降低，年龄和脉压显示出最强的相关性，与房颤的类型无关。此外，主动脉扩张性降低与心血管和全因住院以及房颤复发有关，房颤复发呈四分位数依赖性。