Arterial stiffness (CAVI OR 1.83, p=0.02) and inflammatory markers (hsCRP OR 5.57, p=0.017) were significantly associated with paroxysmal atrial fibrillation in patients with hypertension.
Case-Control (n=163)
Are arterial stiffness and inflammatory markers associated with the occurrence of atrial fibrillation in patients with arterial hypertension?
Increased arterial stiffness and elevated inflammatory markers are significantly associated with the presence of paroxysmal and persistent atrial fibrillation in patients with arterial hypertension.
Odds Ratio: 1.83
p-value: p=0.02
Abstract Background Arterial hypertension (AH) and atrial fibrillation (AF) are two important public health problems and often coexist together. AH ultimately increases the risk of AF and is one of the main reasons for the remodeling process in these patients. However, several factors underlying the higher risk of AF in patients with AH are still incompletely known. Objective To evaluate the possible association between arterial stiffness (AS) and some inflammatory and fibrotic markers that contribute to the AF occurrence in patients with AH. Methods In this study where enrolled 89 patients with AH and non-valvular paroxysmal/persistent AF (mean age 62.6±7.4) after successful cardioversion. As a control group 74 patients with AH and without AF were also examined. Beside the standard examination the echocardiography, 24-hour Holter monitoring and 24-hours BP, we measured the inflammation markers (hsCRP, IL-6, and TGF-β1). AS was evaluated by cardio-ankle vascular index (CAVI). All data were analyzed by SPSS 13.0 using logistic analysis by odds ratio (OR). Results The obtained results showed that in patients with AH and AF, exhibited higher ORs for atrial electrical and structural remodeling in left ventriculum and left atrium, diastolic dysfunction, as well as a significant increase of AS and elevated concentrations of inflammatory markers were detected. In paroxysmal AF, significant predictors included diastolic blood pressure (DBP, OR 1.09, p = 0.017), P-wave maximum duration (Pmax, OR 3.74, p = 0.001), P-wave dispersion (Pdis, OR 3.97, p = 0.001), CAVI (OR 1.83, p=0.02), left atrial volume (LAV, OR 1.76, p=0.013), left atrial stiffness indices (E/e′/LApeak, OR 1.32, p=0.04; E/e′/LAEF, OR 1.41, p=0.02), hsCRP (OR 5.57, p=0.017), and IL-6 (OR 4.80, p=0.001). In persistent AF, a broader set of parameters was associated with AF, including DBP (OR=1.29, р=0.001), Pmax (OR=4.73, p=0.001), Pdis (OR=4.66, p=0.001), CAVI (OR=2.22, p=0.01), left atrial diameter (OR=3.80, p=0.04) and volume LAV (ОШ=3.69, p=0.001), LV end-diastolic volume (OR=1.76, p=0.046), interventricular septum thickness (OR=1.79, p=0.042), left atrial stiffness indices (E/e’/LApeak — OR=1.89, p=0.02; E/e’/LAEF — OR=2.11, p=0.01), IVRT (OR=3.94, p=0.016), hsCRP (OR=6.37, p=0.001), IL-6 (OR=5.78, p=0.000), and TGF-β1 (ОR=3.84, p0.05). Conclusions Multivariate analysis revealed a significant role of left atrial and ventricular dysfunction, inflammation as well as arterial stiffness on the possible risk of AF occurrence in hypertensive patients. These findings underscore the importance of early detection and management of these factors to mitigate AF risk in this population.
Hazarapetyan et al. (Mon,) conducted a case-control in Arterial hypertension and atrial fibrillation (n=163). Arterial stiffness and inflammatory markers vs. Patients with arterial hypertension without atrial fibrillation was evaluated on Paroxysmal atrial fibrillation (OR 1.83, p=0.02). Arterial stiffness (CAVI OR 1.83, p=0.02) and inflammatory markers (hsCRP OR 5.57, p=0.017) were significantly associated with paroxysmal atrial fibrillation in patients with hypertension.
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