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Predictors of Future Atrial Fibrillation Development in Patients with Hypertrophic Cardiomyopathy: A Prospective Follow‐Up Study
Author(s) -
Tuluce Kamil,
Yakar Tuluce Selcen,
Kahya Eren Nihan,
Kocabas Ugur,
Akyildiz Akcay Filiz,
Gunduz Ramazan,
Akyildiz Zehra I.,
Ergene Oktay
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13093
Subject(s) - medicine , cardiology , cutoff , ejection fraction , atrial fibrillation , hypertrophic cardiomyopathy , receiver operating characteristic , heart failure , physics , quantum mechanics
Background We evaluated whether left atrial ( LA ) phasic functions, P‐wave dispersion ( PWD ), and plasma NT ‐pro BNP levels could predict future development of atrial fibrillation ( AF ) in patients with hypertrophic cardiomyopathy ( HCM ). Methods Seventy patients with HCM were evaluated. The LA phasic functions including the LA total emptying volume (LATEV), LA total emptying fraction (LATEF), LA active emptying volume (LAAEV), LA active emptying fraction (LAAEF), LA passive emptying volume (LAPEV), and LA passive emptying fraction (LAPEF) were evaluated. P‐wave dispersion was calculated. Plasma NT ‐pro BNP levels were measured on the same day with echocardiographic study. Results Patients were followed up 53.09 ± 1.87 months. Patients who developed AF (n = 18) had significantly higher PWD values, NT ‐pro BNP levels, LAVI , E/E' av, and resting LVOT gradients and significantly lower LATEF and LAAEF . In multivariate analysis, LATEF (P = 0.002), LAAEF (P = 0.007), log NT ‐pro BNP level (P = 0.022), and PWD (P = 0.018) were associated with AF development. The results of receiver operating characteristic analysis revealed that a LATEF cutoff value 49% with 72% sensitivity and 81% specificity, a LAAEF cutoff value of 36% with 72% sensitivity and 71% specificity, and an NT ‐pro BNP cutoff value of 720 pg/ mL predicted future AF development with 72% sensitivity and 60% specificity. A PWD cutoff value of 47.5 msecond predicted future AF development with 78% sensitivity and 72% specificity. Conclusion In patients with HCM , LA phasic functions, PWD , and NT ‐pro BNP levels predict future development of AF . Assessment of LA phasic functions during routine echocardiographic evaluation and measuring NT ‐pro BNP levels and PWD values of patients with HCM during daily practice may provide important data in predicting those at high risk of AF occurrence.