04 February 2019 by Bahri Akdeniz

Importance of atrial fibrillation in patients with pulmonary arterial hypertension

Introduction

Atrial fibrillation (AF) is known to be due to left heart disease, associated with left atrial dilatation and affecting survival in this group. However we observed AF in some patients in our series.

Aim:

Investigate to prevalence, clinical characteristics of AF and impact on survival in pr-ecapillary PH patients

Method:

All pre-capillary PH patients (n= 183 ) in our PH center followed last 10 years included the study after excluding group 2 PH as well as those with increased PCWP. Medical database were screened in aspects of clinical, echo and hemodynamic data.at all patients. All patients had been followed up 3 month’s interval. Patients were divided 2 groups as those with AF (group 1) and non AF (group 2). Kaplan Meier survival analysis and Cox regression analysis estimated.

Results:

A Total 183 patients (%73, 2 female, mean age: 118 were included and 76 of that died in the follow up period The prevalence of AF was 18.7% (n: 34). There was no difference of sex (p=0.4), functional capacity (p=0.09), BMI (p=0.9), BNP level (0.27), 6MWD (p=0.66),TAPSE (p=0.13), right ventricle diameter (p=0.7), cardiac output (p=0,28). Patient with group 1 have an older age (p=0.03) larger left atrium (p<0.001) lower mPAP (p=0.008) lower PVR (p=0.04) The presence of AF was associated with an increased mortality risk in Cox regression analysis (figure 1).

 

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Conclusion.

The prevalence of AF is unexpectedly high in our pre-capillary PH population. This may be due to elderly PH population having other co-mobidites or masked group 2 patients. The presence of AF influenced survival in pre capillary PH patients.

Key Contributors

Bahri Akdeniz 1, Ebru Özpelit 1, Bihter Şentürk 1, Dilek Sezgin 2, Buse Kahraman Ozcan 3, Melih Birlik 4, Can Sevinc 5 : Dokuz Eylul University Faculty of medicine dept of 1. Cardiology 2. Faculty of Nursing 3. School of Physical Therapy and Rehabilitation 4. Rheumatology, 5. Chest Medicine


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