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Eur Heart J:房颤患者的体育锻炼、心肺适能与心血管结局

2020-02-14 xing.T MedSci原创

由此可见,较高的PA和CRF与AF患者较低的CVD长期风险和全因死亡率相关。该发现支持AF患者常规PA和改善CRF的作用,以应对死亡率和发病率升高的风险。

房颤(AF)会增加死亡率和发病率,但体育活动(PA)和心肺适能(CRF)对AF患者预后的长期影响尚不清楚。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员旨在评估AF患者PA和估计的CRF(eCRF)与全因死亡率、心血管疾病(CVD)死亡率、发病率和卒中的前瞻性关联。

研究人员从2006-2008年期间进行的HUNT3研究中随访了1117例AF患者,直到首次出现结局或在2015年11月结束随访。研究人员使用Cox比例风险回归分析了自我报告的PA和eCRF与患者结局之间的关联。

与不活动的患者相比,符合PA指南的AF患者的全因风险[风险比(HR)为0.55,95%置信区间(CI)为0.41-0.75]和为CVD死亡率(HR为0.54,95%CI为0.34-0.86)较低。CVD发病率和卒中的HR分别为0.78(95%CI为0.58-1.04)和0.70(95%CI为0.42-1.15)。eCRF每增加1个代谢当量任务(MET),全因风险(HR为0.88,95%CI为0.81-0.95)、CVD死亡率(HR为0.85,95%CI为0.76-0.95)和发病率(HR为0.88,95%CI为0.82-0.95)降低。

由此可见,较高的PA和CRF与AF患者较低的CVD长期风险和全因死亡率相关。该发现支持AF患者常规PA和改善CRF的作用,以应对死亡率和发病率升高的风险。

原始出处:


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    2020-11-13 aids222
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    2020-02-16 zhaojie88
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    2020-02-16 slcumt
  6. [GetPortalCommentsPageByObjectIdResponse(id=1684556, encodeId=a0ac1684556d7, content=<a href='/topic/show?id=dfae5133e1d' target=_blank style='color:#2F92EE;'>#心肺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51337, encryptionId=dfae5133e1d, topicName=心肺)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8e128082444, createdName=aids222, createdTime=Fri Nov 13 15:23:00 CST 2020, time=2020-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269363, encodeId=b06e12693635a, content=<a href='/topic/show?id=49d1518915a' target=_blank style='color:#2F92EE;'>#心血管结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51891, encryptionId=49d1518915a, topicName=心血管结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Sun Feb 16 03:23:00 CST 2020, time=2020-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357393, encodeId=2e39135e393bc, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Feb 16 03:23:00 CST 2020, time=2020-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1515028, encodeId=2882151502811, content=<a href='/topic/show?id=3545513e044' target=_blank style='color:#2F92EE;'>#心肺适能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51370, encryptionId=3545513e044, topicName=心肺适能)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55b110706669, createdName=1508842480_96220440, createdTime=Sun Feb 16 03:23:00 CST 2020, time=2020-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563225, encodeId=8066156322502, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun Feb 16 03:23:00 CST 2020, time=2020-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614541, encodeId=ad77161454102, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e19519012, createdName=hittouch, createdTime=Sun Feb 16 03:23:00 CST 2020, time=2020-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031226, encodeId=069a1031226b0, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Fri Feb 14 15:23:00 CST 2020, time=2020-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050327, encodeId=fd0c105032edb, content=运动锻炼应该是健康第一要素,对各类疾病都应该有益。但是国内这方面研究太少, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Fri Feb 14 15:23:00 CST 2020, time=2020-02-14, status=1, ipAttribution=)]
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    2020-02-14 心介

    房颤,临床上碰到很多哦

    0

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    2020-02-14 jingjing

    运动锻炼应该是健康第一要素,对各类疾病都应该有益。但是国内这方面研究太少

    0

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由此可见,在伴有甲亢的NVAF患者中,DOAC可能是华法林的一种有效且安全的替代方法。对于此类患者,可以考虑用DOAC预防血栓形成,因此在进一步的前瞻性研究中验证这一发现很重要。

Circulation子刊称:炎症是哮喘与房颤共同危险因素

2月4日,Circulation心律失常与电生理学子刊发表的MESA研究最新分析结果表明,持续性哮喘患者容易出现房颤,其发生房颤的风险是无哮喘人群的1.5倍。研究者发现,白介素6、肿瘤坏死因子-α受体1、D二聚体等炎症标志物可预测房颤风险,但是校正这些炎症标志物后,持续性哮喘与房颤之间的关系不受影响。研究者指出,炎症是哮喘和房颤的共同危险因素,在该研究中,持续性哮喘患者的炎症生物标志物水平的确最高

Eur Heart J:接受不同口服抗凝药治疗的房颤患者骨折风险

由此可见,与华法林相比,NOAC与AF患者的骨折风险降低有关。因此,如果需要口服抗凝药,则应考虑使用NOAC而非华法林来降低骨折的风险。但是,需要进一步的研究来调查潜在的机制并阐明因果关系。

JACC:口服抗凝药不会降低血透房颤患者的栓塞风险

长期血透的患者出血的风险会增高,尽管口服抗凝药(OACs)可以降低房颤患者卒中风险,但是随机临床试验会将血透的患者排除在外。本荟萃分析的目的旨在评估OACs对接受血透治疗的房颤患者的影响。本研究纳入分析了16个符合标准的观察性研究(N=71877),其中只有2个研究为直接OACs。与未服用抗凝药物相比,apixaban和华法林与卒中和全身性栓塞风险的降低不相关,5mg的apixaban可以降低患者

丹麦研究:房颤患者胃肠道出血,需警惕肠癌!

房颤患者常规服用华法林、达比加群、利伐沙班和阿哌沙班等抗凝药物,以防止血栓形成而导致中风。然而,存在胃肠道出血的风险,估计每年约有1%-2%的患者会出血。近日,欧洲心脏杂志上发表的一项丹麦研究称,应用抗凝治疗的房颤患者如果出现胃肠道出血,建议进行肠癌的筛查,不能单纯认为是抗凝药物的原因。该研究发现,与没有胃肠道出血的患者相比,那些发生出血的患者被诊断为肠癌的可能性高出11-24倍。该研究中,发生消

Eur Heart J:抗凝治疗房颤患者胃肠道出血与结直肠癌风险

由此可见,在接受抗凝治疗的AF患者中,胃肠道出血导致发生结直肠癌的绝对风险升高。GI出血不应作为OAC治疗的良性结局而排除,而应始终评估潜在的恶性病因。

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