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Atrial arrhythmias are associated with increased mortality in pulmonary arterial hypertension
- Source :
- Pulmonary Circulation, Pulmonary Circulation, Vol 8 (2018)
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- Pulmonary arterial hypertension (PAH) is a deadly vascular disease, characterized by increased pulmonary arterial pressures and right heart failure. Considering prior non-US studies of atrial arrhythmias in PAH, this retrospective, regional multi-center US study sought to define more completely the risk factors and impact of paroxysmal and non-paroxysmal forms of atrial fibrillation and flutter (AF/AFL) on mortality in this disease. We identified patients seen between 2010 and 2014 at UPMC (Pittsburgh) hospitals with hemodynamic and clinical criteria for PAH or chronic thromboembolic pulmonary hypertension (CTEPH) and determined those meeting electrocardiographic criteria for AF/AFL. We used Cox proportional hazards regression with time-varying covariates to analyze the association between AF/AFL occurrence and survival with adjustments for potential cofounders and hemodynamic severity. Of 297 patients with PAH/CTEPH, 79 (26.5%) suffered from AF/AFL at some point. AF/AFL was first identified after PAH diagnosis in 42 (53.2%), identified prior to PAH diagnosis in 27 (34.2%), and had unclear timing in the remainder. AF/AFL patients were older, more often male, had lower left ventricular ejection fractions, and greater left atrial volume indices and right atrial areas than patients without AF/AFL. AF/AFL (whether diagnosed before or after PAH) was associated with a 3.81-fold increase in the hazard of death (95% CI 2.64–5.52, p
- Subjects :
- Pulmonary and Respiratory Medicine
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Right heart failure
pulmonary arterial hypertension
Internal medicine
medicine
atrial fibrillation
030212 general & internal medicine
lcsh:RC705-779
business.industry
Vascular disease
Atrial fibrillation
lcsh:Diseases of the respiratory system
Atrial arrhythmias
medicine.disease
3. Good health
atrial flutter
lcsh:RC666-701
Cardiology
business
Atrial flutter
Research Article
Subjects
Details
- ISSN :
- 20458940
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Pulmonary Circulation
- Accession number :
- edsair.doi.dedup.....4cd1da1c710f1c615ecc5b357d17d27e