Document Detail


Impact of atrial fibrillation on outcome of patients with idiopathic dilated cardiomyopathy: data from the Heart Muscle Disease Registry of Trieste.
MedLine Citation:
PMID:  20682760     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: There is a paucity and inconsistency of data regarding the natural history of patients affected by idiopathic dilated cardiomyopathy (IDCM) and atrial fibrillation (AF). We examined the prognostic implications of AF in a subset of patients with IDCM.
METHODS: We analyzed the data of 539 patients with IDCM enrolled in the Heart Muscle Disease Registry of Trieste.
RESULTS: At baseline, 52 (9.6%) of 539 patients had AF. There was no difference in survival of patients with either AF or sinus rhythm at enrollment (P = .28). During long-term follow-up (90 ± 58 months), AF was detected on ECG/ECG-Holter monitoring in 28 (5.7%) of 487 patients in sinus rhythm at baseline. Predictors of new onset of AF at multivariate analysis were a more dilated left atrium (OR 1.35, 95% CI 1.06-1.72; P = .01) and a lower left ventricle ejection fraction (for 10% decrease, OR 2.41, 95% CI 1.24-4.69, P = .016). Patients developing AF had higher mortality/heart transplantation rate compared to patients who maintained sinus rhythm during follow-up (P < .001). At multivariate analysis, new onset AF (HR 3.67, 95% CI 2.07-6.5; P < .001) in the first three years after diagnosis, but not baseline AF, was found to be independently associated with a worse outcome.
CONCLUSIONS: Atrial fibrillation is relatively frequent in patients with IDCM. The early development of AF during follow-up, but not its presence at baseline, is associated with poor survival.
Authors:
Aneta Aleksova; Marco Merlo; Massimo Zecchin; Gastone Sabbadini; Giulia Barbati; Giancarlo Vitrella; Andrea Di Lenarda; Gianfranco Sinagra
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-08-03
Journal Detail:
Title:  Clinical medicine & research     Volume:  8     ISSN:  1554-6179     ISO Abbreviation:  Clin Med Res     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-23     Completed Date:  2011-04-08     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101175887     Medline TA:  Clin Med Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  142-9     Citation Subset:  IM    
Affiliation:
Cardiovascular Department, Ospedali Riuniti, University of Trieste, Trieste, Italy. aaleksova@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Fibrillation / complications,  diagnosis,  mortality*,  physiopathology*,  surgery
Cardiomyopathy, Dilated / complications,  mortality*,  physiopathology*,  surgery
Disease-Free Survival
Electrocardiography
Female
Follow-Up Studies
Heart Transplantation
Humans
Italy
Male
Middle Aged
Registries*
Stroke Volume
Survival Rate
Transplantation, Homologous
Comments/Corrections

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