P6.07 AORTIC STIFFNESS IS AN INDEPENDENT PREDICTOR OF NEW ONSET ATRIAL FIBRILLATION IN CHRONIC HEART FAILURE PATIENTS WITH REDUCED SYSTOLIC FUNCTION
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- 10.1016/j.artres.2010.10.077How to use a DOI?
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Background: Atrial fibrillation (AF) is the commonest supraventricular arrhythmia in chronic heart failure (CHF) with impaired left ventricular (LV) systolic function, The causes of its high incidence and prevalence in CHF are only partially understood.
Aim: To analyze the hemodynamic determinants of incident atrial fibrillation in CHF patients. Particulary, whether indexes of arterial stiffness might identify patients at risk for new onset AF.
Methods: 77 patients (mean age 62.8±9.3 years, ejection fraction 34.5±8.3%, male 80%) were enrolled. All patients underwent a complete echocardiographic-Doppler evaluation. Aortic-pulse wave velocity (PWV) was determined by Doppler flow recordings as previously reported. Effective arterial elastance (Ea) was estimated as end-systolic pressure/stroke volume (SV). Total arterial compliance (SAC) was calculated as SV/PP.
Results: 15 (19.5%) patients developed AF during the follow up. There were no differences in age, SBP, DBP, PP, LV-EF, left atrial volume, plasma neurohormones and procollagens. Those with AF had higher aortic-PWV (7.0±2.5 vs 5.3±1.9 m/sec, p= 0.004), higher Ea (1.68±0.46 vs 1.35±0.47 mmHg/mL, p=0.03), lower SAC (1.57±0.55 vs 1.96±0.53 mL/mmHg, p=0.02), higher time difference between pulmonary vein Ar-wave and mitral A-wave duration (PV-Ar-A) (43.5±44.2 vs 10±34.7 ms, p=0.02) and mitral E-wave velocity (0.76±0.23 vs 0.59±0.24 m/s, p=0.02). In bivariate logistic regression models aortic-PWV predicted always independently incident AF:
| Variables | OR | 95% CI | p-value |
|---|---|---|---|
| Aortic-PWV | 1.4 | 1.07–1.94 | 0.01 |
| SAC | 0.3 | 0.07–0.96 | 0.04 |
| Aortic-PWV | 1.5 | 1.09–1.97 | 0.01 |
| Ea | 2.9 | 0.95–8.9 | 0.06 |
| Aortic-PWV | 1.9 | 1.2–3.0 | 0.003 |
| PV-Ar-A | 1.04 | 1.0–1.07 | 0.01 |
Conclusion: Aortic stiffness independently predicts incident AF in CHF with impaired LV-systolic function.
Cite this article
TY - JOUR AU - S. Bonapace AU - A. Rossi AU - M.A. Cicoira AU - G. Arcaro AU - F. Valbusa AU - E. Barbieri AU - C. Vassanelli PY - 2010 DA - 2010/12/02 TI - P6.07 AORTIC STIFFNESS IS AN INDEPENDENT PREDICTOR OF NEW ONSET ATRIAL FIBRILLATION IN CHRONIC HEART FAILURE PATIENTS WITH REDUCED SYSTOLIC FUNCTION JO - Artery Research SP - 167 EP - 167 VL - 4 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2010.10.077 DO - 10.1016/j.artres.2010.10.077 ID - Bonapace2010 ER -