原发性免疫缺陷中心房颤动的风险：心房电机械延迟和P波离散度评估Risk of atrial fibrillation in primary immunodeficiencies: evaluation of atrial electromechanical delay and P-wave dispersion | Allergologia et Immunopathologia

原发性免疫缺陷中心房颤动的风险：心房电机械延迟和P波离散度评估

作者信息

Mustafa Ilker Inan 土耳其屈塔希亚市医院免疫学与过敏科

Yasemin Akgul Balaban 土耳其宗古尔达克阿塔图尔克州立医院免疫学与过敏科

Ahmet Faruk Yagci 土耳其安卡拉古尔哈内培训和研究医院心脏病科

Cihad Kaya 土耳其安卡拉古尔哈内培训和研究医院心脏病科

Ezgi Sonmez 土耳其安卡拉古尔哈内培训和研究医院免疫学与过敏科

Fikriye Kalkan 土耳其安卡拉比尔肯特市医院免疫学与过敏科

Fevzi Demirel 土耳其安卡拉古尔哈内培训和研究医院免疫学与过敏科

Sait Yesillik 土耳其安卡拉古尔哈内培训和研究医院免疫学与过敏科

Barış Bugan 土耳其安卡拉古尔哈内培训和研究医院心脏病科

Ozgur Kartal 土耳其安卡拉古尔哈内培训和研究医院免疫学与过敏科

关键词

心律失常、心房电机械延迟、心房颤动、免疫系统先天性错误、原发性免疫缺陷

摘要

背景： 原发性免疫缺陷疾病（PIDs）是一组罕见的免疫系统疾病，其分类体系持续扩展。多种临床表现，如自身免疫、免疫失调和炎症反应，可能影响PID患者的多个器官系统。心脏可能是受累器官之一，但针对此领域的研究极为有限。心房颤动（AF）是社区人群中死亡率和发病率的重要诱因，而增大的P波离散度（PWD）和心房电机械延迟（AED）是公认的AF易感性预测标志物。本研究旨在确定AED和/或增大的PWD能否预测PID患者早期AF风险。

方法： 这项单中心前瞻性对照研究纳入61名PID患者和60名对照组受试者。所有参与者均接受静息心电图、超声心动图检查，以及由经验丰富的心脏病专家使用组织多普勒成像评估的心房电机械传导时间（AECT）监测。

结果： 与对照组相比，PID组的P波最大值（Pmax）、最小值（Pmin）和PWD值均具有统计学意义地升高（102 [92–108] vs. 88 [82–99] ms，P < 0.001；74 [70–80] vs. 68 [62–72] ms，P < 0.001；26 [22–30] vs. 21 [18–26] ms，P = 0.001）。PID组的右心房延迟和房间延迟也显著增高（4 [2–6] vs. 2 [2–4] ms，P < 0.001；6 [4–8] vs. 4 [4–6] ms，P = 0.039）。左心房延迟在PID组中同样升高，但差异未达统计学显著性（6 [4–6] vs. 4 [3–6] ms；P = 0.05）。

结论： 本研究证实，AF的已知预测指标AECT和PWD在PID患者中显著增高。这一发现有助于改善PID患者的临床随访和生存预后，通过早期识别与AF相关的死亡率和发病率风险，为这一常伴多种并发症的患者群体提供关键干预窗口。

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