Abstract 18174: Is the Smoldering Inflammation Including Chronic Sinusitis Related to Atrial Fibrillation?

Abstract

Introduction: Comparatively younger patients with atrial fibrillation (AF) are often encountered in clinical practice, without well-known risk factors, that is, aging, thyroid disorder and left ventricular dysfunction. Although the relationship between cardiovascular disease and smoldering inflammation recently attracts attention, it remains unknown whether chronic inflammation is associated with AF. Hypothesis: We assessed the hypothesis that AF is related to the prevalence of smoldering inflammation associated with otorhinolaryngology.

Methods: We enrolled consecutive 508 patients who came to Kyoto Kizugawa cardiology outpatient clinic during September 2011, and collected clinical demographics with medical record extraction and questionnaire method. Hay fever, chronic sinusitis, prior otorhinolaryngological surgery and sleep apnea syndrome (SAS) were focused on. Logistic regression analysis was performed to determine clinical risk factors for AF.

Results: 97 patients (19%) had persistent or paroxysmal AF. In patients with AF, age, monocyte, obvious mitral valve regurgitation (MR) and aortic valve regurgitation were high, while estimated glomerular filtration rate (eGFR), lymphocyte, hypertension, and prior intervention for ischemic heart disease were low. The prevalence of hay fever was equal between AF group and no-AF group (30% v.s. 28%, p=0.7). However, chronic sinusitis (33% v.s. 10%, p<0.0001), prior otorhinolaryngological surgery (11% v.s. 5%, p=0.04) and SAS (9% v.s. 3%, p=0.02) were significantly higher in AF group. After adjustment for other factors including age and gender, chronic sinusitis [odds ratio (OR), 7.33; 95% confidence interval (CI), 1.61-2.40], IRBBB [OR, 6.73; 95% CI, 1.51-2.41], moderate MR [OR, 9.22; 95% CI, 1.52-2.73], Monocyte [OR, 1.37; 95% CI, 0.43-0.92], eGFR [OR, 0.98; 95% CI, 1.00-1.04], and SAS [OR, 3.39; 95% CI, 1.00-2.21] were demonstrated as the independent risk factors for AF. While, prior intervention for ischemic heart disease [OR, 0.14; 95% CI, 0.18-0.69] was an independent predictor for no AF.

Conclusions: Chronic sinusitis, high levels of monocyte, chronic kidney disease and SAS were associated with AF, which suggested that AF might be related with chronic smoldering inflammation.