Impact of Body Mass Index on Postoperative Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy Undergoing Septal Myectomy

Abstract

Background Obesity is an established cardiovascular risk factor in patients with hypertrophic cardiomyopathy. Postoperative atrial fibrillation (POAF) is one of the most common complications after surgery in patients with obstructive hypertrophic cardiomyopathy (OHCM). We aimed to determine the impact of body mass index (BMI) on the occurrence of POAF in patients with OHCM who underwent septal myectomy. Methods and Results In all, 712 OHCM patients without previous atrial fibrillation who underwent septal myectomy were identified. Patients were stratified into 3 groups based on BMI. Of these, 224 (31.5%) had normal weight (BMI<24 kg/m 2 ), 339 (47.6%) were overweight (BMI, 24 to <28 kg/m 2 ), and 149 (20.9%) were obese (BMI≥28 kg/m 2 ). Overweight and obese patients had increased levels of left atrial diameter ( P <0.001) and left ventricular end‐diastolic diameter ( P <0.001), compared with patients with normal weight. Among 184 patients (25.8%) developing POAF, 32 cases (14.3%) occurred in the normal weight group, 100 cases (29.5%) occurred in the overweight group, and 52 cases (34.9%) occurred in the obese group ( P <0.001). Logistic regression analysis indicated that overweight (odds ratio [OR]: 2.161, 95% CI, 1.333–3.503; P =0.002) or obesity (OR, 2.803; 95% CI, 1.589–4.944; P <0.001), age (OR, 1.037; 95% CI, 1.018–1.057; P <0.001), and left atrial diameter (OR, 1.060; 95% CI, 1.027–1.095; P <0.001) were independently associated with the occurrence of POAF in patients with OHCM. Conclusions Overweight and obesity are strong predictors of POAF in patients with OHCM. Strategies aimed at lowering BMI may be a potential way to prevent POAF.

Association of heart rate variability and atrial fibrillation in patients with obstructive hypertrophic cardiomyopathy

“…The results of our previous study demonstrated that age and BMI are independent risk factors for perioperative AF in patients with HCM [34], suggesting that HRV may play a role in the development of AF through age and BMI. Moreover, LAD was positively correlated with the rMSSD (p < 0.01) and pNN50 (p < 0.01), although the correlation between left atrial size and All rights reserved.…”

“…We also found a negative correlation between the SDNN and both age (p < 0.01) and BMI (p < 0.01), suggesting that total autonomic tone activity decreases with age and BMI. The results of our previous study demonstrated that age and BMI are independent risk factors for perioperative AF in patients with HCM [34], suggesting that HRV may play a role in the development of AF through age and BMI. Moreover, LAD was positively correlated with the rMSSD (p < 0.01) and pNN50 (p < 0.01), although the correlation between left atrial size and AF has been widely verified [35], suggesting that changes in parasympathetic nervous system tension may be associated with the occurrence of AF through changes in left atrial size.…”

High expression of long noncoding RNA plasmacytoma variant translocation 1 is an independent risk factor for recurrence after radiofrequency ablation in atrial fibrillation patients

“…To further evaluate the effects of lncRNA PVT1 on the recurrence of AF, the recurrence of AF was taken as the dependent variable, combined with the analysis results in Table 3 and the possible risk factors affecting AF previously reported 18–20 . Age, gender, HA, TGF‐β1, LAD, LVEDD, LAVI, LVRI, and lncRNA PVT1 were included in the binary logistic multivariate regression analysis model as independent variables.…”

“…To further evaluate the effects of lncRNA PVT1 on the recurrence of AF, the recurrence of AF was taken as the dependent variable, combined with the analysis results in Table 3 and the possible risk factors affecting AF previously reported. [18][19][20] Age, gender, HA, TGF-β1, LAD, LVEDD, LAVI, LVRI, and lncRNA PVT1 were included in the binary logistic multivariate regression analysis model as independent variables. Multivariate logistic regression analysis demonstrated that after adjusting the sizes of LAVI and LVRI, and the level of TGF-β1, lncRNA PVT1 was the independent risk factor for postoperative recurrence of AF (p = 0.038, OR = 16.056, 95% CI: 1.170-220.359) (Tables 5 and 6).…”