背景:新的证据表明儿童虐待与心血管疾病风险有关;然而,儿童虐待与心律失常之间的关联尚不清楚.此外,心房颤动(AF)的任何遗传易感性,与中风风险升高相关的常见心律失常,心力衰竭,和死亡率,修改此类关联的文件没有记录在案。目的:研究儿童虐待与偶发心律失常之间的关系,以及心律失常的遗传易感性是否改变了这些关联。方法:这项前瞻性分析包括来自英国生物银行的151,741名参与者(平均年龄55.8岁,43.4%男性)。童年虐待,包括五种类型,使用儿童创伤筛查(CTS)进行测量。偶发心律失常(房颤,室性心律失常[VA],和缓慢性心律失常[BA])通过关联的入院和死亡登记处进行记录。计算加权AF遗传风险评分。进行Cox比例风险模型以测试儿童虐待与偶发心律失常之间的关联。结果:在12.21年的中位随访期间(四分位距,11.49-12.90年),6,588AF,2,093BA,发生742例VA事件。与没有儿童虐待相比,有3-5种类型的儿童虐待与房颤事件风险增加相关(HR,1.23;95CI1.09-1.37),VA(HR,1.39;95CI1.03-1.89),和BA(HR,1.32;95CI1.09-1.61)调整人口统计后,社会经济和生活方式因素。儿童虐待的累积类型与房颤风险(总体总体<.001;Pnear=.674)和BA(总体=.007;Pnear=.377)之间的关联显示出线性模式。在中等和高遗传风险组(Ptrend均<0.05)中,但在低遗传风险组(Ptrend=.378)中,儿童虐待和AF风险之间存在梯度关联。与不显著的交互效应无关(P交互效应=.204)。结论:儿童虐待与心律失常的发生风险较高有关,尤其是AF和BA。房颤的遗传风险并没有改变这些关联。
先前的研究表明,儿童虐待与心血管疾病风险有关。儿童虐待与偶发心律失常的风险增加有关,特别是心房颤动和缓慢性心律失常。房颤的遗传易感性并未显着改变这些关联。童年虐待可能是晚年心律失常的一个新的心理危险因素。对儿童虐待和随后转介心理服务的询问可能会有所帮助。
Background: Emerging evidence has linked childhood maltreatment with cardiovascular disease risk; however, the association between childhood maltreatment and cardiac
arrhythmias remains unclear. Moreover, any genetic predispositions to atrial fibrillation (AF), a common cardiac arrhythmia associated with an elevated risk of stroke, heart failure, and mortality, that modify such associations have been undocumented.Purpose: To examine the associations between childhood maltreatment and incident
arrhythmias, and whether a genetic predisposition to
arrhythmias modifies these associations.Methods: This prospective analysis included 151,741 participants from the UK Biobank (mean age 55.8 years, 43.4% male). Childhood maltreatment, including five types, was measured using the Childhood Trauma Screener (CTS). Incident
arrhythmias (AF, ventricular
arrhythmias [VA], and bradyarrhythmia [BA]) were documented through linked hospital admission and death registry. Weighted AF genetic risk score was calculated. Cox proportional hazard models were conducted to test for associations between childhood maltreatment and incident arrhythmias.Results: During a median follow-up of 12.21 years (interquartile range, 11.49-12.90 years), 6,588 AF, 2,093 BA, and 742 VA events occurred. Compared with the absence of childhood maltreatment, having 3-5 types of childhood maltreatment was associated with an increased risk of incident AF (HR, 1.23; 95%CI 1.09-1.37), VA (HR, 1.39; 95%CI 1.03-1.89), and BA (HR, 1.32; 95%CI 1.09-1.61) after adjusting demographic, socioeconomic and lifestyle factors. The associations between cumulative type of childhood maltreatment and the risk of AF (Poverall < .001; Pnonlinear = .674) and BA (Poverall = .007; Pnonlinear = .377) demonstrated a linear pattern. There was a gradient association between childhood maltreatment and AF risks across the intermediate and high genetic risk groups (both Ptrend < .05) but not within the low genetic risk group (Ptrend = .378), irrespective of non-significant interaction effect (Pinteraction = .204).Conclusion: Childhood maltreatment was associated with higher risks of incident
arrhythmias, especially AF and BA. Genetic risk of AF did not modify these associations.
Previous studies indicate that childhood maltreatment is associated with cardiovascular disease risk.Childhood maltreatment was associated with an increased risk of incident arrhythmias, particularly atrial fibrillation and bradyarrhythmia. Genetic predisposition to atrial fibrillation did not significantly modify these associations.Childhood maltreatment could be a new psychological risk factor for cardiac arrhythmias in later life. Inquiries into childhood maltreatment and subsequent referral to psychological services may be helpful.