超常肺功能与心房颤动新发。
Supranormal lung function and incident atrial fibrillation.
文献信息
| PMID | 42788843 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xiu Shi |
| 作者单位 | Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China. |
| 期刊 | Pulmonology |
| SCI 分区 | Q1 |
| IF | 5.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 超常肺功能是否与心房颤动（AF）新发相关，以及阻塞性睡眠呼吸暂停（OSA）是否改变这种关联，仍有待确定。
方法： 我们分析了睡眠心脏健康研究中2,408名基线时无AF且无肺功能气流阻塞的参与者。主要分析使用种族中立的全球肺功能倡议（GLI）Global（2022）参考方程，将第1秒用力呼气容积（FEV1）分类为低于正常、正常或超常。在二次分析中检查了由用力肺活量（FVC）定义的类别。使用多变量逻辑回归评估与新发AF的关联，以估计比值比（OR）和95%置信区间（CI）。使用Firth惩罚逻辑回归和敏感性分析评估结果的稳健性。探讨了与OSA的交互作用。
结果： 在2,408名参与者中，282人发生AF。与正常FEV1相比，在主要调整模型中，超常FEV1与新发AF的较低比值相关（OR，0.420；95% CI，0.198-0.888）。相应的Firth估计值为0.443（95% CI，0.199-0.869）。超常FVC在标准逻辑回归（OR，0.351；95% CI，0.167-0.736）和Firth惩罚逻辑回归（OR，0.371；95% CI，0.168-0.721）中显示出相似的关联。关联方向在敏感性分析中总体一致。没有统计学显著证据表明OSA存在效应修饰。
结论： 超常肺功能与新发AF的较低比值相关。这些发现支持将超常肺功能测定作为有利的全身和心肺生理学的潜在标志物。
英文摘要
BACKGROUND: Whether supranormal lung function is associated with incident atrial fibrillation (AF), and whether obstructive sleep apnoea (OSA) modifies this association, remain to be determined.
METHODS: We analysed 2,408 participants from the Sleep Heart Health Study who were free of AF at baseline and had no spirometric airflow obstruction. The primary analysis classified forced expiratory volume in 1 second (FEV1) as below normal, normal, or supranormal using race-neutral Global Lung Function Initiative (GLI) Global (2022) reference equations. Categories defined by forced vital capacity (FVC) were examined in a secondary analysis. Associations with incident AF were evaluated using multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Firth penalised logistic regression and sensitivity analyses were used to assess the robustness of the findings. Interaction with OSA was explored.
RESULTS: Among 2,408 participants, 282 developed AF. Compared with normal FEV1, supranormal FEV1 was associated with lower odds of incident AF in the primary adjusted model (OR, 0.420; 95% CI, 0.198-0.888). The corresponding Firth estimate was 0.443 (95% CI, 0.199-0.869). Supranormal FVC showed a similar association in standard logistic regression (OR, 0.351; 95% CI, 0.167-0.736) and Firth penalised logistic regression (OR, 0.371; 95% CI, 0.168-0.721). The direction of the associations was generally consistent across sensitivity analyses. There was no statistically significant evidence of effect modification by OSA.
CONCLUSIONS: Supranormal lung function was associated with lower odds of incident AF. These findings support supranormal spirometry as a potential marker of favourable systemic and cardiopulmonary physiology.