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Clinical impact of atrial fibrillation in patients with pulmonary hypertension
- Source :
- PLoS ONE, Vol 7, Iss 3, p e33902 (2012), PLoS ONE
- Publication Year :
- 2012
- Publisher :
- Public Library of Science (PLoS), 2012.
-
Abstract
- Background Pulmonary hypertension (PH) is associated with progressive impairment of right ventricular function, reduced exercise capacity and a poor prognosis. Little is known about the prevalence, clinical manifestation and impact of atrial fibrillation (AF) on cardiac function in PH. Methods In a four year single-centre retrospective analysis 225 patients with confirmed PH of various origins were enrolled to investigate the prevalence of AF, and to assess the clinical manifestation, 6-minute walk distance, NT-proBNP levels, echocardiographic parameters and hemodynamics obtained by right heart catheterization in PH with AF. Results AF was prevalent in 31.1%. In patients with PH and AF, parameters of clinical deterioration (NYHA/WHO functional class, 6-minute walk distance, NT-proBNP levels) and renal function were significantly compromised compared to patients with PH and sinus rhythm (SR). In the total PH cohort and in PH not related to left heart disease occurrence of AF was associated with an increase of right atrial pressure (RAP) and right atrial dilatation. While no direct association was found between pulmonary artery pressure (PAP) and AF in these patients, right ventricular function was reduced in AF, indicating more advanced disease. In PH due to left heart failure the prevalence of AF was particularly high (57.7% vs. 23.1% in other forms of PH). In this subgroup, left atrial dilatation, increase of pulmonary capillary wedge pressure, PAP and RAP were more pronounced in AF than in SR, suggesting that more marked backward failure led to AF in this setting. Conclusion PH is associated with increased prevalence of AF. Occurrence of AF in PH indicates clinical deterioration and more advanced disease.
- Subjects :
- Male
Cardiac function curve
Cardiac Catheterization
medicine.medical_specialty
Clinical Research Design
Hypertension, Pulmonary
lcsh:Medicine
Cardiovascular
Ventricular Function, Left
Diagnostic Radiology
Internal medicine
medicine.artery
Atrial Fibrillation
Natriuretic Peptide, Brain
medicine
Humans
Pulmonary wedge pressure
lcsh:Science
Aged
Retrospective Studies
Multidisciplinary
business.industry
lcsh:R
Hemodynamics
Central venous pressure
Atrial fibrillation
Middle Aged
Prognosis
medicine.disease
Pulmonary hypertension
Peptide Fragments
Blood pressure
Echocardiography
Nephrology
Heart failure
Pulmonary artery
Exercise Test
Cardiology
Medicine
Atrial Function, Left
Female
lcsh:Q
Radiology
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 7
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....2a6e29cc0d39cded2ca010bc4a1fcfb5