Objective: To evaluate the clinical characteristics and risk factors for atrial fibrillation(AF)in patients with obstructive hypertrophic cardiomyopathy(OHCM). Methods: Patients with OHCM hospitalized in Fuwai Hospital from March 2011 to January 2016 were enrolled in the present study. Each patient underwent examinations including transthoracic echocardiography, body surface electrocardiograph or dynamic electrocardiogram (Holter). Cardiac troponin I (cTNI) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP)levels were tested and clinical profiles were collected.The subjects were divided into two groups (the AF group and non-AF group). Risk factors for AF in patients with OHCM were assessed by multivariate logistic regression analysis. Results: A total of 309 patients were evaluated in the study. Among them, 17.5%( 54/309) patients were with AF.Age[(51.2±10.1)years vs (43.1 ± 14.4)years], New York Heart Association class(NYHA class)(2.8±0.5 vs 2.6±0.6), disease duration[6.0(4.0, 10.0)years vs 3.0(1.0, 6.0)years], left atrial (LA) dimension[(45.1±7.0)mm vs(42.6 ± 7.4)mm]and NT-pro-BNP levels[2 007(1 565, 3 199)pmol/L vs 1 509(729, 2 921)pmol/L]in the AF group were significantly higher than those in the non-AF group (all P<0.05). Multivariate logistic regression analysis indicated that advanced age(OR=1.04, 95% CI 1.01-1.08, P<0.01), higher NYHA class(OR=2.00, 95% CI 1.08-3.70, P<0.05)and longer disease duration(OR=1.08, 95% CI 1.01-1.15, P<0.05)were independent risk factors for AF in patients with OHCM, in which advanced age(OR=1.05, 95% CI 1.02-1.09, P<0.01), higher NYHA class(OR=3.39, 95% CI 1.53-7.54, P<0.01), LA dimension(OR=1.06, 95% CI 1.01-1.12, P<0.05)and longer clinical course(OR=1.12, 95% CI 1.04-1.20, P<0.01)were associated with AF in male patients, and advanced age (OR=1.05, 95% CI 1.01-1.09, P<0.05)and longer disease duration(OR=1.14, 95% CI 1.01-1.28, P<0.01)were associated with AF in female patients when stratified by gender. Conclusion: Advanced age , higher NYHA class and longer clinical duration are independent risk factors for AF in OHCM patients.
目的：探讨梗阻性肥厚型心肌病合并心房颤动(房颤)患者的临床特点和危险因素。方法：将阜外医院2011年3月至2016年1月住院的梗阻性肥厚型心肌病患者作为研究对象，收集患者临床资料及相关检查结果；根据有无房颤将研究对象分为房颤组和无房颤组，比较其临床特点，并采用多因素logistic回归分析研究梗阻性肥厚型心肌病患者发生房颤的危险因素。结果：共309例梗阻性肥厚型心肌病患者入选，其中合并房颤54例(17.5%)。房颤组与无房颤组在年龄[(51.2±10.1)岁比(43.1 ± 14.4)岁]、纽约心脏病学会心功能分级(NYHA分级)(2.8±0.5比2.6±0.6)、病程[6.0(4.0，10.0)年比3.0(1.0，6.0)年]、左心房内径[(45.1±7.0)mm比(42.6 ± 7.4)mm]、B型利钠肽前体[2 007(1 565，3 199)pmol/L比1 509(729，2 921)pmol/L]的差异均有统计学意义(P<0.05)。对于男性患者，年龄、NYHA分级、病程以及左心房内径为房颤的危险因素(P值均<0.05)；而女性患者只有年龄和病程为房颤的危险因素(P值均<0.05)。多因素logistic回归分析发现，高龄(OR＝1.04，95% CI 1.01～1.08, P<0.01)、NYHA分级差(OR＝2.00，95% CI 1.08～3.70，P<0.05)、病程长(OR＝1.08，95% CI 1.01～1.15，P<0.05)是梗阻性肥厚型心肌病患者房颤发生的独立危险因素。结论：高龄、NYHA分级差和病程长是梗阻性肥厚型心肌病患者发生房颤的独立危险因素。.
Keywords: Atrial fibrillation; New York Heart Association class; Obstructive hypertrophic cardiomyopathy.