Abstract 3892: Pulmonary Hypertension is a Frequent Finding in Patients with Atrial Fibrillation
Background Atrial fibrillation (AF) is associated with substantial implications on morbidity and mortality. The association of AF with pulmonary disease has been described. However, no studies have addressed the frequency of pulmonary hypertension (PH) in patients with AF. The purpose of our study was to document the prevalence of PH in patients with AF.
Methods This is a retrospective study that included 685 patients hospitalized in our institution between July 2001 and July 2003. First, 343 patients with AF were identified through medical records and data obtained for demographics, history, electrocardiograms, and echocardiography studies. Echocardiography reports within 3–6 months were evaluated for pulmonary artery systolic pressure (PASP), ejection fraction (EF), left atrial size, and other cardiac abnormalities. Second, 342 patients without AF were identified. These patients were matched to the AF-group by age and EF. PH was diagnosed if the PASP was ≥ 40 mmHg at rest. PASP was determined by an equation that included the square of tricuspid regurgitant jet velocity multiplied by 4. AF was diagnosed if documented by history and at least one electrocardiogram. Data was analyzed using SPSS software.
Results A total of 685 patients were included in the analysis. PH was found in 200 (58.3%) patients in the AF group vs. 106 (31.0%) patients in the non-AF group (p <0.001), with mean PASPs of (43.36±13.19) mmHg and (35.51±13.29) mmHg, respectively (p<0.001). Mean age was (69.74±14.82) years, and 57.8% were female. Chronic pulmonary disease was found in 81 (23.6%) patients in the AF group vs. 93 (27.2%) patients in the non-AF group (p=0.28). Multivariate analysis showed that the presence of AF (OR=4.71, 95% CI 3.09–7.17, p <0.001), age ≥65, female gender, and left-sided valvular heart lesions, were significantly associated with PH. EF, diastolic dysfunction, and chronic pulmonary disease, were not found to be significantly associated with PH.
Conclusion Pulmonary hypertension determined by echocardiography is a frequent finding in patients with atrial fibrillation. This represents an important underreported finding in patients with atrial fibrillation.