1 / 19

Enes Abdovic Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Etiology distribution of patients with atrial fibrilation by echocardiography: results from a prospective study in 3755 adults. Enes Abdovic Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina. Purpose. Purpose.

velma
Download Presentation

Enes Abdovic Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Etiology distribution of patients with atrial fibrilation by echocardiography: results from a prospective study in 3755 adults Enes Abdovic Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

  2. Purpose Purpose • Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia 1 • It is a disease of the elderly and it is common in patients with structural heart disease1 • Hypertension (HA), diabetes mellitus, myocardial infarction,heart failure (with impaired or preserved left ventricular systolic function), and valvular heart disease are recognized predisposing factors to AF2,3,4 • Objectives: To evaluate predisposing factors for development of AF in our hospital settings 1Go AS, et al. JAMA 2001;285:2370–75. 2Aidietis A, et al. Curr Pharm Des 2007;13:2545–55. 3Grigioni F, et al. J Am Coll Cardiol 2002;40:84–92. 4Olsson LG, et al. J Am Coll Cardiol 2006;47:1997–2004.

  3. Methods Methods • From June 2000 to February 2013, 3755 consecutive patients with AF were studied during echocardiographic check-up • According to transthoracic echo, patients were divided in groups based on dominative underlying heart diseases • Electrocardiographically documented AF was subdivided in two groups: transitory and chronic • Transitory AF fulfilled criteria for paroxysmal or persistent AF1 • Chronic AF were cases of long-standing persistent or permanent AF1 • Binary logistic regression was used to investigate relationship of gender, age, hypertension, diabetes and underlying heart diseases with the type of AF Camm AJ, et al. Eur Heart J 2010;31:2369–2429.

  4. Results • The median age was 72 years, age range between 16 and 96 years • There were 51.4% of females. • Chronic AF was observed in 68.3% pts. • Lone AF was diagnosed in only 25 patients, mostly in younger males (median age 48 years, range 29–59, men 80%)

  5. Etiological distribution AF by echocardiography (3755 pts) HHD=hypertensive heart disease; DCM=dilated cardiomyopathy; CAD=coronary artery disease; VHD=valvular heart disease; Lone=lone AF; HF=heart failure; AF=atrial fibrillation.

  6. Comorbidities associated with AF No=number; pts=patients; AF=atrial fibrillation; BMI=body mass index; HHD=hypertensive heart disease; DCM=dilated cardiomyopathy; CAD=coronary artery disease; VHD=valvular heart disease; Lone=lone AF.

  7. Comorbidities associated with AF No=number; pts=patients; AF=atrial fibrillation; BMI=body mass index; HHD=hypertensive heart disease; DCM=dilated cardiomyopathy; CAD=coronary artery disease; VHD=valvular heart disease; Lone=lone AF.

  8. AF and HA pts (2854=76%) HHD=hypertensive heart disease; DCM=dilated cardiomyopathy; CAD=coronary artery disease; VHD=valvular heart disease; Lone=lone AF; HF=heart failure; AF=atrial fibrillation.

  9. AF and HF pts (1832=49%) HHD=hypertensive heart disease; DCM=dilated cardiomyopathy; CAD=coronary artery disease; VHD=valvular heart disease; Lone=lone AF; HF=heart failure; AF=atrial fibrillation.

  10. Characteristics of patients with chronic vs. transitory AF No=number; pts=patients; AF=atrial fibrillation; SD=standard deviation, yrs=years, BMI=body mass index; LBBB=left bundle branch block; TIA=transitory ischemic attack.

  11. Results (2) Results (2) • Hypertensive heart disease (HHD) was the most common underlying heart disease (40.2%) followed by dilated cardiomyopathy (DCM), 24.9%, coronary artery disease (CAD), 13.9% and valvular heart disease (VHD), 11.1%. • Thyroid gland disease was found in 240:6.3% of patients of which 52.9% was hypothyroidism (127 vs 113)

  12. Results (2) Results (3) • Hypertension, diabetes and thyroid gland disease were found in 75.4%, 18.8% and 6.3% patients, respectively, mostly in females: • (HA: 1556pts/2832=55.0%) • (DM: 453pts/706=64.2%) • (Thy.gl.disease: 193pts/240=80.4%)

  13. Risk of chronic atrial fibrillation (binary logistic regression model) HHD, hypertensive heart disease; DCM, dilated cardiomyopathy; CHD, coronary artery disease; VHD, valvular heart disease; Lone, lone atrial fibrillation; BMI, body mass index; HA, hypertension; DM, diabetes mellitus; TH, diseases of thyroid gland; IVB, intraventricular block.

  14. Pts with/without Paroxismal AFAged ≥65yrs and/or with LAE ≥ 25 and/or with IAB

  15. CHA2DS2-VASc score ≥2 = 86.5%

  16. Conclusion Conclusion • Hypertension was by far the most prevalent associated medical condition in patients with AF • AF without underlying heart disease was present in only 0.7%, mostly in younger patients, males, with transitory AF • Almost 1/2 of pts with AF had HF and 59.2% had diastolic HF. • Chronic AF was predominant in groups with advanced cardiac remodeling such as DCM and VHD, mostly in elderly

  17. Conclusion Take Home Message • Optimal treatement of HA as well as DM • to prevent CAD and HF and • to eliminate or at least postpone AF, the most common sustained cardiac arrhythmia

More Related