NT Pro‐BNP can be used as a risk predictor of clinical atrial fibrillation with or without left atrial enlargement

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. In western countries, rheumatic heart disease (RHD) is a rare cause of atrial fibrillation but in developing countries like India it is one of the commonest cause of atrial fibrillation. We studied etiology, left atrial size and the incidence of left atrial appendage clot in patients with atrial fibrillation at our institution so that guidelines could be formulated to manage the patients of AF in the hours of emergency.Methods: 110 consecutive patients of atrial fibrillation coming to emergency, cardiology and medicine outpatient department over a period of one year were enrolled for the study. Ethical committee clearance was taken. Detailed history were taken, clinical presentation reviewed and examination were carried out. All patients were subjected to transthoracic echocardiography and for transesophageal echocardiography if required.Results: The mean age of patients in the study was 58.42±14.27 years (range 22-90 years). Maximum numbers of patients were in the age group of 61-70 years (26.37%). Out of 110 patients with atrial fibrillation, 72 patients (65.46%) were females and 38 patients (34.54%) were males. Majority of patients presented with more than one symptom. Out of 110, 66 patients (60%) had RHD. Among RHD patients, 50 patients (45.55%) were females and 16 patients (14.55%) were males. Next common causes were hypertensive heart disease and degenerative valvular heart disease.Conclusions: In our study RHD was the most common cause of atrial fibrillation, followed by hypertensive heart disease and degenerative valvular heart disease. Mitral valve involvement was seen in all patients of RHD. Left atrial enlargement was seen in majority of patients, so left atrial enlargement could be a predictor of atrial fibrillation. Patients of left atrial enlargement are more prone to develop left atrial appendage clot.

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Left Atrial Enlargement Correlates with Inflammation and Oxidative Stress in Patients at High Risk for Atrial Fibrillation

Journal of Clinical & Experimental Cardiology ◽

10.4172/2155-9880.1000101 ◽

2010 ◽

Vol 01 (01) ◽

Cited By ~ 1

Author(s):

Heather L. Bloom ◽

Irfan Shukrullah ◽

William Jang ◽

Richard N. Vest III ◽

Samuel C. Dudley

Keyword(s):

Oxidative Stress ◽

Atrial Fibrillation ◽

High Risk ◽

Left Atrial ◽

Left Atrial Enlargement ◽

Atrial Enlargement ◽

And Oxidative Stress

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P5658Incorporation of severity of left atrial enlargement in clinical risk factors improves identification of patients at risk for development of atrial fibrillation

European Heart Journal ◽

10.1093/eurheartj/ehz746.0601 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

D Chawla ◽

S Olet ◽

M E Mortada ◽

J Zilinski ◽

K A Ammar ◽

...

Keyword(s):

Atrial Fibrillation ◽

At Risk ◽

Left Atrial ◽

Roc Analysis ◽

Roc Curves ◽

Volume Index ◽

Clinical Predictors ◽

Left Atrial Enlargement ◽

Patients At Risk ◽

Atrial Enlargement

Abstract Background Early identification of patients at risk for atrial fibrillation (AF) is desirable to prevent its development and complications. Clinical predictors have been recognized but need refinement to improve predictability. We evaluated whether severity of left atrial enlargement (LAE) added to a scoring system (CHA2DS2VASC) in an unselected non-AF population improves risk stratification for incident AF. Purpose To assess the incremental benefit of LAE severity added to CHA2DS2VASc in predicting future AF in non-AF patients. Methods From 2012–2017, consecutive adult patients with an echocardiogram and no prior AF were identified. CHA2DS2VASc was used to define baseline AF risk, and the incremental risk of AF with addition of LAE was assessed through increased LA volume index (LAVI; moderate 42–48 ml/m2, severe >48 ml/m2). To quantify improvement in risk prediction, logistic regression model was fitted and odds ratios (OR) and ROC curves obtained. Results Out of 155,597 patients with no prior AF, 13.8% developed AF over 1.5±1.3 years. OR for AF with CHA2DS2VASc was 1.68 (95% CI 1.66–1.69). With addition of moderately or severely increased LAVI to the model, OR for AF increased to 2.3 (2.2–2.5) and 3.8 (3.6–4.0), respectively. ROC analysis showed c-statistics of 0.66 with CHA2DS2VASc, 0.63 with LAVI, and 0.71 with incorporation of both (Fig). AF CHAD score Conclusion(s) In non-AF patients, predictability for future AF can be improved by using clinical factors (CHA2DS2VASc) and increased LAVI. This information may guide closer monitoring and initiation of therapies to prevent progression to AF or stroke. Acknowledgement/Funding None

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