Risks for atrial fibrillation and congestive heart failure in patients ≥65 years of age with abnormal left ventricular diastolic relaxation

2004 ◽  
Vol 93 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Teresa S.M Tsang ◽  
Marion E Barnes ◽  
Bernard J Gersh ◽  
Kent R Bailey ◽  
James B Seward
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Left Ventricular ◽  
Diastolic Relaxation

Plasmin-α2-antiplasmin Complex in Patients with Atrial Fibrillation

1999 ◽  
Vol 82 (07) ◽  
pp. 100-103 ◽  
Author(s):  
William Feinberg ◽  
Elizabeth Macy ◽  
Elaine Cornell ◽  
Sarah Nightingale ◽  
Lesly Pearce ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Linear Regression ◽  
Clinical Characteristics ◽  
Stroke Risk ◽  
Left Ventricular ◽  
Recent Onset ◽  
Poor Left Ventricular Function ◽  
Fractional Shortening

SummaryPlasmin-α2-antiplasmin complex (PAP) is an index of recent fibrinolytic activity. We examined PAP levels in patients with atrial fibrillation (AF) to determine whether these levels are correlated with clinical characteristics associated with stroke risk. We obtained blood for measurement of PAP in a non-random sample of 586 patients with AF on entering the Stroke Prevention in Atrial Fibrillation III Study. PAP levels were measured with an ELISA assay. PAP values were transformed with a natural logarithm (PAPln) prior to all analyses. Older age, female gender, recent congestive heart failure, decreasing fractional shortening, recent onset of AF, and coronary artery disease were each univariately associated with higher levels of PAP (all p <0.05, two-sample t-test, simple linear regression). Older age, recent congestive heart failure, decreasing fractional shortening, and recent onset of AF were independently associated with higher PAP levels by multivariate analysis (linear regression). Among patients receiving warfarin, PAP levels were not correlated with INR levels (linear regression, p = 0.60). Patients classified as high-risk for thromboembolism by our risk stratification criteria (systolic blood pressure >160 mm Hg, prior thromboembolism, recent congestive heart failure, poor left ventricular function, and women over age 75) had higher PAP levels than low-risk patients (antilog mean PAPln 5.6 vs 4.9, p <0.001, two-sample t-test). PAP levels in patients with AF are associated with clinical characteristics predictive of thromboembolism. Elevated PAP levels are particularly associated with poor left ventricular function and are not affected by anticoagulation. PAP levels may be a marker of stroke risk in patients with AF.Presented in part at the American Heart Association 22nd annual Joint Conference on Stroke and the Cerebral Circulation, Anaheim, CA, February, 1997.

scholarly journals Predictors of progression of atrial fibrillation in patients with congestive heart failure

2017 ◽  
Vol 95 (7) ◽  
pp. 613-617
Author(s):  
V. I. Podzolkov ◽  
A. I. Tarzimanova ◽  
L. Mohammadi
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Multifactorial Analysis ◽  
Telephone Interviews ◽  
Observation Period

An appreciable progress has recently been achieved in the study of the nature of atrial fibrillation (AF), from its early asymptomatic stages to irreversible arrhythmia. There are data on the risk factors of AF in the literature, but predictors of progressive arrhythmia remain to be elucidated. This study was aimed to identify predictors of AF progression in patients with congestive heart failure (CHF). Material and methods. The study involved 64 patients aged 59-82 (mean 69,4±3,9) followed up prospectively from September 2010 till June 2016 (observations of mean duration 60±3 mo included regular telephone interviews (each 3 mo) and annual general clinical examination with laboratory and instrumental studies. Continuous or persisting AF served as the criterion for progressive arrhythmia. Results. Cardiovascular complications and progressive arrhythmia were documented in 23 (36%) and 38 (59%) patients respectively during the 60±3 mo observation period. The multifactorial analysis revealed the significant influence of a decrease of left ventricular ejection function (EF) to below 40% and a rise in the plasma level of brain natriuretic peptide (Nt-proBNP) to more than 903 pg/ml on the risk of development of arrhythmia. Conclusion. Independent predictors of arrhythmia in patients with CHF and persistent AF are a decrease in left ventricular ejection function (EF) to below 40% (1,2, 95% CI 0,9-1,5) and a rise in the plasma Nt-proBNP level to more than 903 pg/ml (OR 1,3, 95% , CI+1,1-2,9). Such a rise predicts transition of arrhythmia into continuous form with sensitivity 92,1% and specificity 84,6%.

scholarly journals The Thromboembolic Predictability of CHA2DS2-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation

2022 ◽  
Vol 11 (2) ◽  
pp. 300
Author(s):  
Albert Youngwoo Jang ◽  
Woong Chol Kang ◽  
Yae Min Park ◽  
Kyungeun Ha ◽  
Jeongduk Seo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Left Ventricular ◽  
Hazard Ratio ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cox Regression Analysis ◽  
Original Definition

The association between congestive heart failure (CHF) of the CHA2DS2-VASc scores and thromboembolic (TE) events in patients with atrial fibrillation (AF) is a topic of debate due to conflicting results. As the importance of diastolic impairment in the occurrence of TE events is increasingly recognized, it is crucial to evaluate the predictive power of CHA2DS2-VASc scores with C criterion integrating diastolic parameters. We analyzed 4200 Korean nonvalvular AF patients (71 years of age, 59% men) to compare multiple echocardiographic definitions of CHF. Various guideline-suggested echocardiographic parameters for systolic or diastolic impairment, including left ventricular ejection fraction (LVEF) ≤ 40%, the ratio of early diastolic mitral inflow velocity to early diastolic velocity of the mitral annulus (E/E’) ≥ 11, left atrial volume index > 34 mL/m2, and many others were tested for C criteria. Multivariate-adjusted Cox regression analysis showed that CHA2DS2-VASc score was an independent predictor for composite thromboembolic events only when CHF was defined as E/E’ ≥ 11 (hazard ratio, 1.26; p = 0.044) but not with other criteria including the original definition (hazard ratio, 1.10; p = 0.359). Our findings suggest that C criterion defined as diastolic impairment, such as E/E’ ≥ 11, may improve the predictive value of CHA2DS2-VASc scores.

Atrial fibrillation in patients hospitalized for congestive heart failure: The same prognostic influence independently of left ventricular systolic function?

2006 ◽  
Vol 110 (3) ◽  
pp. 366-372 ◽  
Author(s):  
Lilian Grigorian Shamagian ◽  
Alfonso Varela Roman ◽  
Javier Garcia Seara ◽  
Jose Luis Martinez Sande ◽  
Pedro Rigueiro Veloso ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Ventricular Systolic Function

Evaluation of left ventricular based pacing in patients with congestive heart failure and atrial fibrillation

1999 ◽  
Vol 83 (7) ◽  
pp. 1138-1140 ◽  
Author(s):  
Yves Etienne ◽  
Jacques Mansourati ◽  
Martine Gilard ◽  
Valérie Valls-Bertault ◽  
Jacques Boschat ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Left Ventricular
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