Update on atrial fibrillation

Shenasa, Mohammad; Shenasa, Hossein; Soleimanieh, Mona

doi:10.1016/j.ehj.2014.03.004

Cited by 5 publications

(2 citation statements)

References 74 publications

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“…(hypertension, smoking, obesity, diabetes mellitus, renal failure, sleep apnea, coronary artery disease) and similar pathophysiology [neurohormonal failure, activation of the renin–angiotensin–aldosterone system (RAAS), increased filling pressures and afterload, increased stretch, and fibrosis of the left atrium]. Pathophysiologic changes in the failing heart (the structural and neurohormonal changes) promote episodes of AF (about 1/3 of HF patients will develop AF) and promote AF from paroxysmal to permanent ( 12 ). The incidence of AF in the HF population rises with the New York Heart Association (NYHA) class (from 4% in NYHA class I to 50% in NYHA class IV) ( 12 ), while AF diagnosis in turn predisposes to the development of HF in the future (2- to 3-fold increased risk of incident HF) ( 8 , 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

“…Pathophysiologic changes in the failing heart (the structural and neurohormonal changes) promote episodes of AF (about 1/3 of HF patients will develop AF) and promote AF from paroxysmal to permanent ( 12 ). The incidence of AF in the HF population rises with the New York Heart Association (NYHA) class (from 4% in NYHA class I to 50% in NYHA class IV) ( 12 ), while AF diagnosis in turn predisposes to the development of HF in the future (2- to 3-fold increased risk of incident HF) ( 8 , 11 , 12 ). Concomitant HF leads to higher mortality in AF subjects ( 8 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

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The Relationship of Dehydration and Body Mass Index With the Occurrence of Atrial Fibrillation in Heart Failure Patients

Chuda

Kaszkowiak

Banach

et al. 2021

Front. Cardiovasc. Med.

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Purpose: The aim of the study was to assess the relationship of dehydration, body mass index (BMI) and other indices with the occurrence of atrial fibrillation (AF) in heart failure (HF) patients.Methods: The study included 113 patients [median age 64 years; 57.52% male] hospitalized due to HF. Baseline demographics, body mass analysis, echocardiographic results, key cardiopulmonary exercise test (CPET) parameters, 6 min walk distance (6MWD) and Kansas City Cardiomyopathy Questionnaire (KCCQ) score were assessed.Results: Of all patients, 23 (20.35%) had AF, and 90 (79.65%) had sinus rhythm (SR). Patients with AF were older (med. 66 vs. 64 years; p = 0.039), with higher BMI (32.02 vs. 28.51 kg/m2; p = 0.017) and percentage of fat content (37.0 vs. 27.9%, p = 0.014). They were more dehydrated, with a lower percentage of total body water (TBW%) (45.7 vs. 50.0%; p = 0.022). Clinically, patients with AF had more often higher New York Heart Association (NYHA) class (III vs. II; p < 0.001), shorter 6MWD (median 292.35 vs. 378.4 m; p = 0.001) and a lower KCCQ overall summary score (52.60 vs. 73.96 points; p = 0.002). Patients with AF had significantly lower exercise capacity as measured by peak oxygen consumption (peak VO2) (0.92 vs. 1.26 mL/min, p = 0.016), peak VO2/kg (11 vs. 15 mL/kg/min; p < 0.001), and percentage of predicted VO2max (pp-peak VO2) (62.5 vs 70.0; p=0.010). We also found VE/VCO2 (med. 33.85 vs. 32.20; p = 0.049) to be higher and peak oxygen pulse (8.5 vs. 11 mL/beat; p = 0.038) to be lower in patients with AF than in patients without AF. In a multiple logistic regression model higher BMI (OR 1.23 per unit increase, p < 0.001) and higher left atrial volume index (LAVI) (OR 1.07 per unit increase, p = 0.03), lower tricuspid annular plane systolic excursion (TAPSE) (OR 0.74 per unit increase, p =0.03) and lower TBW% in body mass analysis (OR 0.90 per unit increase, p =0.03) were independently related to AF in patients with HF.Conclusion: Increased volume of left atrium and right ventricular systolic dysfunction are well-known predictors of AF occurrence in patients with HF, but hydration status and increased body mass also seem to be important factors of AF in HF patients.

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