Signs of left atrial disease and 10-year risk of atrial fibrillation

被引:1
|
作者
Uhe, Tobias [1 ]
Stegmann, Tina [1 ]
Langhammer, Romy [1 ]
Dagres, Nikolaos [2 ]
Laufs, Ulrich [1 ]
Wachter, Rolf [1 ]
机构
[1] Univ Klinikum Leipzig, Klin & Poliklin Kardiol, Leipzig, Germany
[2] Herzzentrum Leipzig, Abt Rhythmol, Leipzig, Germany
来源
PLOS ONE | 2022年 / 17卷 / 04期
关键词
P-WAVE INDEXES; NATRIURETIC PEPTIDE; CRYPTOGENIC STROKE; ATHEROSCLEROSIS RISK; PREMATURE BEATS; ISCHEMIC-STROKE; PREDICTORS; COHORT; VOLUME;
D O I
10.1371/journal.pone.0266848
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
BackgroundThe contribution of left atrial disease and excessive supraventricular ectopic activity (ESVEA) to the risk for incident atrial fibrillation (AF) is incompletely understood. ObjectiveTo analyse the ten-year risk to develop AF in patients with cardiovascular risk factors and to define the impact of parameters of left atrial disease and ESVEA on AF risk. Methods148 patients from the Diast-CHF trial with at least one cardiovascular risk factor and free of AF at baseline were followed for 10 years. Left atrial disease was defined as left atrial volume index (LAVI) >35 ml/m(2), P-terminal force in lead V-1 (PTFV1) >4000 ms*mu V or elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) >250 pg/ml. We analyzed the association of these parameters and ESVEA (either >720 premature atrial contractions (PAC) or one atrial run >20 beats per day) on AF-free survival. ResultsAfter ten years, AF was newly detected in twelve patients (13.4%) with signs of left atrial disease and two patients (3.4%) without signs of left atrial disease (p = 0.04). LAVI (p = 0.005), ESVEA (p = 0.016) and NT-proBNP (p = 0.010) were significantly associated with AF-free survival in univariate analysis. A combined Cox model of left atrial disease parameters showed associations for NT-proBNP (HR 3.56; 95%CI 1.33-5.31; p = 0.04) and PAC (HR 2.66; 95%CI 1.25-10.15; p = 0.01) but not for LAVI or PTFV1 with AF-free survival. ConclusionThe risk for AF is higher in patients with cardiovascular risk factors and signs of left atrial disease. NT-proBNP and premature atrial contractions independently predict AF-free survival. The role of excessive supraventricular ectopic activity for the assessment of AF risk may be underestimated and requires further study.
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页数:11
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