Prevalence and echocardiographic predictors of atrial fibrillation in patients with heart failure with preserved ejection fraction

Abstract

Aim. To study the occurrence of atrial fibrillation (AF) in patients withnormal ejection fraction heart failure (NEJHF) without AF in anamnesis,and to perform comparative analysis of echocardiographic parameterswith the parameters of patients with NEJHF and known AF, as to studyindependent predictors of AF occurrence in NEJHF.Material and methods. Totally, 182 patients included (105 women)with metabolic syndrome and NEJHF (II-III functional classes by NYHA)at the age 63±12 y. o., with sinus rhythm and no anamnesis of AF(n=118), and with paroxysmal AF (PxAF) in anamnesis (n=28) orpersistent (PeAF) in anamnesis (n=36).Results. Among 118 patients with AF in anamnesis, in 49 (41,5%)during 3 years of follow-up, there were cases of PeAF and PxAF.Patients without AF in anamnesis had better relations for left and rightventricles filling comparison (E/e`) under load, index of maximum leftatrium volume (LA) (IVLAmax), systolic pressure in pulmonary artery(SPPA) during rest and after exertion, than patients with knownepisodes of PeAF and PxAF. Patients with PeAF had significantly highervalues of the index of post systolic shortening of the left ventricle,rigidity index of LA, IVLAmax, E/e` of RV, interatrial mechanicalasynchrony and low values of longitudinal deformation of the LA (LDLA)and velocity parameters of LDLA (VPLDLA). Female sex, systolicarterial pressure, SPPA, IVLAmax, E/e` in load, E/e` of RV, LDLA,longitudinal deformation of the left ventricle and VPLDLA wereindependent predictors of AF.Conclusion. Increased rigidity, parameters of longitudinal deformationand the volume of LA, as interatrial mechanical asynchrony are strongindependent predictors of AF in NEJHF.

Keywords

• heart failure with preserved ejection fraction
• atrial fibrillation
• longitudinal deformation of the left atrium
• predictors