Factors Associated with the Development of Atrial Fibrillation in Chronic Obstructive Pulmonary Disease
Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
*Corresponding author: Olesya V. Melnichenko, PhD, Department of Internal Medicine, Nizhny Novgorod State Medical Academy, 6-58, Trudovaya str., 603155, Nizhny Novgorod, Russian Federation. Tel.: 7-831-436-9976, Fax: 7-831-436-9976. E-mail: firstname.lastname@example.org
Background: It is well established that atrial fibrillation (AF) could develop in patients with chronic obstructive pulmonary disease (COPD); however, its predictors are not quite clear. The aim of this study was to investigate the cardiovascular, hormonal and bronchial obstruction markers and their possible relation to AF risk in COPD.
Methods: Echocardiographic data, resting pulmonary artery mean pressure (PAP) by Doppler ultrasound assessment, N-terminal B-type natriuretic peptide NT-pro-BNP), aldosteronee levels, plasma renin activity, and spirometry parameters in 153 patients with COPD was carefully studied. During follow up, between 8 and 26 months, 18 patients developed an outcome event of atrial fibrillation (AF).
Results: On univariate analysis, renin activity (p=0.007), left atrium (p=0.015), right atrium (p=0.028) and right ventricle (p=0.001), left ventricle systolic (p=0.012) and diastolic (p=0.010) diameters were noted to be predictors of AF, although PAP, NT-pro-BNP levels or FEV1 (p>0.05) were not. However, on multivariate analysis, renin activity (1.14 [1.03; 1.24], p=0.006) and right ventricular diameter (1.39 [1.11; 1.72], p=0.003) were found to be AF predictors.
Conclusion: The plasma rennin activity and right ventricular diameter were found to be the most reliable markers of AF risk in COPD patients from among all the investigated echocardiographic and biochemical parameters.
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