TY - JOUR
T1 - Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women
AU - Tsang, Teresa S.M.
AU - Gersh, Bernard J.
AU - Appleton, Christopher P.
AU - Tajik, A. Jamil
AU - Barnes, Marion E.
AU - Bailey, Kent R.
AU - Oh, Jae K.
AU - Leibson, Cynthia
AU - Montgomery, Samantha C.
AU - Seward, James B.
PY - 2002/11/6
Y1 - 2002/11/6
N2 - OBJECTIVES: The objective of this study was to determine whether diastolic dysfunction is associated with increased risk of nonvalvular atrial fibrillation (NVAF) in older adults with no history of atrial arrhythmia. BACKGROUND: Few data exist regarding the relationship between diastolic function and NVAF. METHODS: The clinical and echocardiographic characteristics of patients age ≥65 years who had an echocardiogram performed between 1990 and 1998 were reviewed. Exclusion criteria were history of atrial arrhythmia, stroke, valvular or congenital heart disease, or pacemaker implantation. Patients were followed up in their medical records to the last clinical visit or death for documentation of first AF. RESULTS: Of 840 patients (39% men; mean [± SD] age, 75 ± 7 years), 80 (9.5%) developed NVAF over a mean (± SD) follow-up of 4.1 ± 2.7 years. Abnormal relaxation, pseudonormal, and restrictive left ventricular diastolic filling were associated with hazard ratios of 3.33 (95% confidence interval [CI], 1.5 to 7.4; p = 0.003), 4.84 (95% CI, 2.05 to 11.4; p < 0.001), and 5.26 (95% CI, 2.3 to 12.03; p < 0.001), respectively, when compared with normal diastolic function. After a number of adjustments, diastolic function profile remained incremental to history of congestive heart failure and previous myocardial infarction for prediction of NVAF. Age-adjusted Kaplan-Meier five-year risks of NVAF were 1%, 12%, 14%, and 21% for normal, abnormal relaxation, pseudonormal, and restrictive diastolic filling, respectively. CONCLUSIONS: The presence and severity of diastolic dysfunction are independently predictive of first documented NVAF in the elderly.
AB - OBJECTIVES: The objective of this study was to determine whether diastolic dysfunction is associated with increased risk of nonvalvular atrial fibrillation (NVAF) in older adults with no history of atrial arrhythmia. BACKGROUND: Few data exist regarding the relationship between diastolic function and NVAF. METHODS: The clinical and echocardiographic characteristics of patients age ≥65 years who had an echocardiogram performed between 1990 and 1998 were reviewed. Exclusion criteria were history of atrial arrhythmia, stroke, valvular or congenital heart disease, or pacemaker implantation. Patients were followed up in their medical records to the last clinical visit or death for documentation of first AF. RESULTS: Of 840 patients (39% men; mean [± SD] age, 75 ± 7 years), 80 (9.5%) developed NVAF over a mean (± SD) follow-up of 4.1 ± 2.7 years. Abnormal relaxation, pseudonormal, and restrictive left ventricular diastolic filling were associated with hazard ratios of 3.33 (95% confidence interval [CI], 1.5 to 7.4; p = 0.003), 4.84 (95% CI, 2.05 to 11.4; p < 0.001), and 5.26 (95% CI, 2.3 to 12.03; p < 0.001), respectively, when compared with normal diastolic function. After a number of adjustments, diastolic function profile remained incremental to history of congestive heart failure and previous myocardial infarction for prediction of NVAF. Age-adjusted Kaplan-Meier five-year risks of NVAF were 1%, 12%, 14%, and 21% for normal, abnormal relaxation, pseudonormal, and restrictive diastolic filling, respectively. CONCLUSIONS: The presence and severity of diastolic dysfunction are independently predictive of first documented NVAF in the elderly.
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U2 - 10.1016/S0735-1097(02)02373-2
DO - 10.1016/S0735-1097(02)02373-2
M3 - Article
C2 - 12427417
AN - SCOPUS:0037032224
SN - 0735-1097
VL - 40
SP - 1636
EP - 1644
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 9
ER -