고혈압과 관상동맥 심장질환은 심방 세동의 가장 흔한 기저 질환입니다

고혈압과 관상동맥 심장질환은 심방 세동의 가장 흔한 기저 질환입니다.

Hypertensive heart disease and coronary heart disease (CHD) are the most common underlying chronic disorders in patients with atrial fibrillation (AF) in developed countries. Rheumatic heart disease, although now uncommon in developed countries, is associated with a much higher incidence of AF. Paroxysmal AF (PAF) is associated with the same disorders as chronic (permanent) AF.

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고혈압 병력은 심방 세동 발생 위험을 1.42배 올리며 상대적으로 작은 증가이지만, 일반 인구에서 고혈압 빈도가 높기 때문에 고혈압성 심장 질환이 심방 세동의 가장 흔한 기저 질환입니다.

In a longitudinal study of male air crew recruits, a history of hypertension increased the risk of developing AF 1.42-fold. Although this is a relatively small increase in risk, the high frequency of hypertension in the general population results in hypertensive heart disease being the most common underlying disorder in patients with AF.

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관상동맥 심장질환이 급성 심근경색이나 심부전으로 합병되지 않는다면 심방 세동은 흔하게 관상동맥 심장질환과 관련되어 있지 않습니다. 심방 세동은 (추정) 심방 허혈 또는 심부전에 의한 atrial stretching으로 인하여 급성 심근 경색 환자에서 일시적으로 6-10% 정도 발생합니다.

AF is not commonly associated with CHD unless it is complicated by acute myocardial infarction (MI) or heart failure (HF). AF occurs transiently in 6 to 10 percent of patients with an acute MI, presumably due to atrial ischemia or atrial stretching secondary to HF. These patients have a worse prognosis that is mostly due to comorbidities such as older age and HF. The incidence of AF is much lower in patients with chronic stable CHD. In the Coronary Artery Surgical Study (CASS), which included over 18,000 patients with angiographically documented coronary artery disease, AF was present in only 0.6 percent . These patients probably had chronic AF; the prevalence of PAF may be higher. AF was associated with age greater than 60, male sex, mitral regurgitation (MR), and HF; there was no association between AF and the number of coronary arteries involved.

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REF. UpToDate 2019.08.19