The Evaluation What Cause Heart Failure in the Patient Has Paroxysmal Atrial Fibrillation with Preserved Systolic Function

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Background: Atrial fibrillation (AF) sometimes cause heart failure (HF) even if a patient has preserved left ventricular (LV) systolic function, but there is unclear what factor lead to heart failure. Methods and Results: From 2008 Sep to 2010 Sep, 180 patients with AF divide decompensate group (DECO, n=33) is led into NYHA III or IV HF and not decompensate group (NOR, n=147) is otherwise. We exclude under ejection fraction (EF) 55%, adaptation of valvular disease. Data are described consecutively DECO and NOR. Age is 75.3±9.5, 65.1±12.6 (p<0.0001). Male gender is 45.5% and 71.4% (p=0.004). Hypertension is 93.9%, 59.9% (p=0.0002). Hypertrophic cardiomyopathy is 33.3% and 12.9% (p=0.0045). Ischemic heart disease is 21.2% and 6.8% (p=0.01). Chronic kidney disease is 21.2% and 8.2% (p=0.028). Left atrial diameter is 43.3±7.9 mm and 39.1±6.0 mm (p=0.0008). The e′ is 5.1±1.6 cm/s and 7.2±2.1 cm/s (p<0.0001). E/e′ is 19.0±12.0 and 11.2±4.5 (p<0.0001). Heart rate on attack is 136±20 bpm and 121±37 bpm (p=0.052). Diabetes mellitus, stroke, valvular disease, medications, LV diastolic diameter, LV systolic diameter, EF, and E/A have no significant difference. Multivariable logistic regression analysis shows that E/e′ and age have relative risks 1.138 (95%CI, 1.026–1.261) and 1.069 (95%CI, 1.008–1.133), respectively. Conclusion: E/e′ and age are independent predictors of HF when patient fall into paroxysmal AF with preserved systolic function.

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