Abstract 15336: Predictors of New-Onset Atrial Fibrillation in the Setting of Essential Hypertension
Objective: We investigated the predictive value of clinical, electrocardiographic and echocardiographic parameters for the incidence of new-onset atrial fibrillation (AF) in essential hypertensives.
Methods: We prospectively followed up for a median period of 3.6 years (IQ 2.7-5.3 years) 2073 uncomplicated hypertensives without history of AF episodes (aged 58.1±11 years). All subjects had at least one visit annually and at entry underwent 12 lead ECG (measuring duration of P wave, QRS and corrected QT interval) and complete echocardiographic study, including left ventricular diastolic function evaluation by means of transmitral flow (E, A, E/A ratio) and tissue Doppler imaging (Em, Am).
Results: The incidence of new-onset AF over the whole follow-up period was 3.5% (39 patients with paroxysmal AF and 33 patients with permanent AF). Patients with new-onset AF compared to those without were older (by 9 years, p<0.001) and exhibited at baseline higher office pulse pressure (by 6.5 mmHg, p=0.005), waist circumference (by 3.9 cm, p=0.01), left ventricular mass index (by 10.7 g/m², p=0.001), left atrium diameter (by 4 mm, p<0.001) and E/Em ratio (12.5±6 vs. 10.5±4, p=0.008), while no difference was observed with respect to gender, baseline diabetes status and body mass index. Moreover, hypertensives with new-onset AF compared with those without had at baseline increased P wave duration (117.8±23 vs. 111±17 ms, p=0.003) and QRS duration (100.5±20 vs. 95.3±13 ms, p=0.002). By applying multivariate Cox regression analysis left atrium diameter (HR 3.501, p<0.001), age (HR 1.069, p<0.001) and QRS duration (HR=1.012, p=0.048) were independently associated with the incidence of new-onset AF.
Conclusions: Aging, left atrium enlargement and prolonged ventricular depolarization, instead of left ventricular mass, turned out to be the only independent predictors of new-onset AF in the setting of essential hypertension.
- © 2012 by American Heart Association, Inc.