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Echocardiographically Derived Pulse Wave Velocity and Diastolic Dysfunction Are Associated with an Increased Incidence of Atrial Fibrillation in Patients with Systolic Heart Failure.

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Echocardiographically Derived Pulse Wave Velocity and Diastolic Dysfunction Are Associated with an Increased Incidence of Atrial Fibrillation in Patients with Systolic Heart Failure.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bonapace, Stefano Rossi, Andrea Cicoira, Mariantonietta Targher, Giovanni Marino, Paolo Benfari, Giovanni Mugnai, Giacomo Arcaro, Guido Vassanelli, Corrado
Description	Country affiliation: Italy Author Affiliation: Bonapace S ( Section of Cardiology, University of Verona, Verona, Italy.); Rossi A ( Section of Cardiology, University of Verona, Verona, Italy.); Cicoira M ( Section of Cardiology, University of Verona, Verona, Italy.); Targher G ( Section of Endocrinology, Diabetes and Metabolism, University of Verona, Verona, Italy.); Marino P ( Clinical Cardiology and Cardiology Department, University of Eastern Piemonte, Novara, Italy.); Benfari G ( Section of Cardiology, University of Verona, Verona, Italy.); Mugnai G ( Section of Cardiology, University of Verona, Verona, Italy.); Arcaro G ( Division of Internal Medicine, Sacred Heart Hospital, Negrar, Negrar, Italy.); Vassanelli C ( Section of Cardiology, University of Verona, Verona, Italy.)
Abstract	BACKGROUND: Chronic heart failure (CHF) is an established risk factor of atrial fibrillation (AF), but the prognostic value of cardiac and hemodynamic parameters in assessing the risk of developing AF among patients with CHF is less defined. METHODS AND RESULTS: We followed an outpatients cohort of CHF patients secondary to left ventricular (LV) systolic dysfunction, who were free of AF at baseline. All patients underwent clinical evaluation, comprehensive echocardiography, and blood drawing in the same morning. Aortic pulse wave velocity (aPWV), a measure of aortic stiffness, was determined by Doppler echocardiography. A total of 77 patients (age 63 ± 9 years; 79% male) with mean LVEF (34 ± 8%) formed the study population. Fifteen patients developed incidental AF. At baseline, CHF patients who developed AF during follow-up had higher E-wave velocity (75 ± 2 cm/sec vs. 60 ± 2 cm/sec; P = 0.02), higher difference duration between mitral and pulmonary vein A velocity (A'-A), (10 ± 35 msec vs. 43 ± 44 msec P = 0.02), aPWV (7.1 ± 2.6 vs. 5.3 ± 1.9 m/sec P = 0.004), and furosemide dosage (110 ± 145 mg vs. 49 ± 48 mg P = 0.01) than those remaining free from AF. The two groups of patients did not significantly differ in terms of NYHA, LV volumes, ejection fraction, left atrial volume, creatinine, hemoglobin, renin, epinephrine, amino-terminal propeptide of type III and I procollagens, ACE inhibitor, and ß-blocker dose (P > 0.1 for all). Notably, higher aPWV (P = 0.01) and longer A-A' duration (P = 0.04) were associated with an increased incidence of AF, independently of potential confounders. CONCLUSIONS: Increased aortic stiffness and LV diastolic dysfunction are strong predictors of new onset of AF among patients with systolic CHF.
File Format	HTM / HTML
ISSN	07422822
Issue Number	7
Journal	Echocardiography
Volume Number	33
e-ISSN	15408175
Language	English
Publisher	Wiley
Publisher Date	2016-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Cardiology and Cardiovascular Medicine

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Echocardiographically Derived Pulse Wave Velocity and Diastolic Dysfunction Are Associated with an Increased Incidence of Atrial Fibrillation in Patients with Systolic Heart Failure.