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Effect of Systemic Hypertension With Versus Without Left Ventricular Hypertrophy on the Progression of Atrial Fibrillation (from the Euro Heart Survey).

Erküner, Ö; Dudink, EAMP; Nieuwlaat, R; Rienstra, M; Van Gelder, IC; Camm, AJ; Capucci, A; Breithardt, G; LeHeuzey, J-Y; Lip, GYH; et al. Erküner, Ö; Dudink, EAMP; Nieuwlaat, R; Rienstra, M; Van Gelder, IC; Camm, AJ; Capucci, A; Breithardt, G; LeHeuzey, J-Y; Lip, GYH; Crijns, HJGM; Luermans, JGLM (2018) Effect of Systemic Hypertension With Versus Without Left Ventricular Hypertrophy on the Progression of Atrial Fibrillation (from the Euro Heart Survey). Am J Cardiol, 122 (4). pp. 578-583. ISSN 1879-1913 https://doi.org/10.1016/j.amjcard.2018.04.053
SGUL Authors: Camm, Alan John

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Abstract

Hypertension is a risk factor for both progression of atrial fibrillation (AF) and development of AF-related complications, that is major adverse cardiac and cerebrovascular events (MACCE). It is unknown whether left ventricular hypertrophy (LVH) as a consequence of hypertension is also a risk factor for both these end points. We aimed to assess this in low-risk AF patients, also assessing gender-related differences. We included 799 patients from the Euro Heart Survey with nonvalvular AF and a baseline echocardiogram. Patients with and without hypertension were included. End points after 1 year were occurrence of AF progression, that is paroxysmal AF becoming persistent and/or permanent AF, and MACCE. Echocardiographic LVH was present in 33% of 379 hypertensive patients. AF progression after 1 year occurred in 10.2% of 373 patients with rhythm follow-up. In hypertensive patients with LVH, AF progression occurred more frequently as compared with hypertensive patients without LVH (23.3% vs 8.8%, p = 0.011). In hypertensive AF patients, LVH was the most important multivariably adjusted determinant of AF progression on multivariable logistic regression (odds ratio 4.84, 95% confidence interval 1.70 to 13.78, p = 0.003). This effect was only seen in male patients (27.5% vs 5.8%, p = 0.002), while in female hypertensive patients, no differences were found in AF progression rates regarding the presence or absence of LVH (15.2% vs 15.0%, p = 0.999). No differences were seen in MACCE for hypertensive patients with and without LVH. In conclusion, in men with hypertension, LVH is associated with AF progression. This association seems to be absent in hypertensive women.

Item Type: Article
Additional Information: © 2018 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Keywords: 1102 Cardiovascular Medicine And Haematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Am J Cardiol
ISSN: 1879-1913
Language: eng
Dates:
DateEvent
15 August 2018Published
11 May 2018Published Online
19 April 2018Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 29958714
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109957
Publisher's version: https://doi.org/10.1016/j.amjcard.2018.04.053

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