Hemodynamic, echocardiographic, and demographic profiles of patients with chronic thromboembolic pulmonary hypertension and atrial fibrillation: A multicenter cohort study.
Marta Braksator, Marcin Kurzyna, Grzegorz Kopeć, Piotr Pruszczyk, Ewa Mroczek, Tatiana Mularek-Kubzdela, Ilona Skoczylas, Piotr Błaszczak, Łukasz Chrzanowski, Miłosz Jaguszewski, Katarzyna Mizia-Stec, Zbigniew Gąsior, Grzegorz Grześk, Wojciech Jacheć, Ewa Lewicka, Katarzyna Ptaszyńska-Kopczyńska, Michał Tomaszewski, Ewa Malinowska, Szymon Darocha, Marcin Waligóra, Magdalena Jachymek, Maciej Lewandowski, Małgorzata Peregud-Pogorzelska
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引用次数: 0
Abstract
Objective: Atrial fibrillation (AFib) reduces the quality of life and increases hospitalization frequency in patients with pulmonary hypertension (PH). Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of PH with a specific pathophysiology, treatment methods, and demographics; however, the factors that correlate with AFib in this population have not yet been determined. This study aimed to investigate the variables that influence the AFib development in patients with CTEPH and assess the impact of arrhythmia on the mortality rate in this population.
Design: Data were obtained from the Database of Pulmonary Hypertension in the Polish Population (NCT03959748), a registry containing data on patients with pulmonary arterial hypertension and CTEPH who were diagnosed and treated in all Polish PH Centers.
Participants: This study included 784 adult patients diagnosed with CTEPH.
Exposure: We compared echocardiographic, hemodynamic, and demographic variables between patients with and without AFib during database enrollment (retrospective arm) and with and without AFib diagnosis during follow-up (prospective arm).
Results: A total of 106 patients (13,5%) with CTEPH were already diagnosed with AFib at enrollment to the registry. We observed a higher incidence of arterial hypertension and chronic renal disease in the arrhythmia than in the non-arrhythmia group. According to the logistic regression analysis, the independent risk factors for AFib development were only pulmonary artery wedge pressure (PAWP, odds ratio [OR] 1,27 per mmHg, 95% confidence interval [CI] 1,082-1,497, p=0,004) and Left Atrial Area (LA area, OR 1,279, 95% CI 1,109-1,476, p=0,001). AFib is associated with higher serum N-terminal prohormone of natriuretic peptide (NTproBNP) levels and is not an independent predictor of mortality.
Conclusions: AFib in patients with CTEPH is related to comorbidities similar to those in the general population. The independent predictors of arrhythmia occurrence are PAWP and LA area, suggesting dominant role of left heart disease in AFib development. Atrial fibrillation does not remain an independent predictor of mortality in patients with CTEPH but is associated with increased NTproBNP serum levels.
期刊介绍：
The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.
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