Abstract 10239: Comparisons of Prognostic Factors Between Chronic Heart Failure Patients with and Without Atrial Fibrillation
Backgrounds: Atrial fibrillation (AF) is associated with an increased risk of mortality and heart failure progression. On the other hand, heart failure is accompanied by an increased risk of AF. However, impact of AF on prognostic factors in chronic heart failure (CHF) has not been rigorously examined.
Purpose: To compare prognostic factors between CHF patients with and without AF.
Methods: We examined consecutive 527 CHF patients (479 males, age 59 ± 14 years) who underwent cardiopulmonary exercising testing (CPX), echocardiography and blood examination at the same time in our hospital. Patients were divided into two groups: AF group (n=130) and non-AF group (n=397). We compared blood testing data, exercise capacity, cardiac function and prognosis between CHF patients with AF and non-AF groups. Patients were followed up (average period: 381±239 days) to register cardiac deaths and re-hospitalization due to worsening heart failure.
Results: There were 89 cardiac events during follow up period. Cardiac event rate was significantly higher in AF group than in non-AF group (26.2% vs. 13.9%, P < 0.001). In non-AF group, multivariate Cox hazard analysis demonstrated that body mass index (Hazard ratio (HR): 0.703, 95% confidence interval (CI): 0.564-0.887, P < 0.01), log BNP (HR: 3.039, CI: 1.339-6.896, P < 0.01), deceleration time (HR: 0.987, CI: 0.978-0.997, P < 0.05), peak VO2 (HR: 0.784, CI: 0.634-0.969, P < 0.05) and exercional periodic breathing (HR: 3.689, CI: 1.471-9.240, P < 0.01) were independent factors to predict adverse clinical outcomes. On the other hand, sodium concentration (HR: 0.864, CI: 0.772 - 0.967, P < 0.01), hemoglobin concentration (HR: 0.746, CI: 0.559-0.998, P < 0.05) were independent parameters to predict cardiac events in AF group.
Conclusions: Prognostic factors were different between CHF patients with and without AF, and this should be considered to manage CHF patients with AF.
- © 2011 by American Heart Association, Inc.