Risk Factors and Their Significance During Sinus Rhythm Before the Onset of Non-valvular Atrial Fibrillation Detected in the Chronological Records of “Ningen Dock” Medical Examinations

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  • 人間ドック健診の経年記録で検出された非弁膜症性心房細動発症例の洞調律時のリスク要因と意義
  • ニンゲン ドックケンシン ノ ケイネン キロク デ ケンシュツ サレタ ヒベンマクショウセイ シンボウ サイドウ ハッショウレイ ノ ドウチョウリツジ ノ リスク ヨウイン ト イギ

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Abstract

<p>Objective: We evaluated risk factors and their prophylactic significance of sinus rhythm in case with non-valvular atrial fibrillation (NVAF) detected in records of “Ningen Dock” medical examinations. </p><p>Method: Of the 90 cases in which NVAF was recorded on standard 12-lead ECG of 3,186 Ningen Dock examinees (2,212 males, 974 females between April 2020 and March 2021), sinus rhythm was demonstrated in the past time-series records of 30 confirmed cases (29 males, 1 female) <pre-AF sinus rhythm group>. The control group consisted of 172 consecutive sinus rhythm groups (SR) (169 males and 3 females) who underwent Ningen Dock medical examinations within the same period and were adjusted for age and sex. </p><p>Results: Significant items in the logistic analysis of 30 patients with pre-symptomatic sinus rhythm before the onset of NVAF were BMI (≧29), blood pressure, cardiothoracic ratio (CTR≧50), silhouette signs on chest X-ray, and left atrial load on electrocardiogram (negative P in precordial V1). The newly devised NVAF prediction score was higher in the pre-AF sinus rhythm group than in the control (8.1 ± 1.7 vs 3.8 ± 1.7, p<0.0001). The cutoff value based on the NVAF prediction score was 6 (area under the curve AUC 0.961), with a high sensitivity and specificity (0.86, 0.967). </p><p>Conclusions: Obesity, cardiac enlargement, left atrial load, and silhouette signs are useful risk factors for the development of NVAF. There are expected to prevent and enlight the onset of NVAF.</p>

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