Clinical impact of atrial fibrillation in patients with pulmonary hypertension
Pulmonary hypertension (PH) is associated with progressive impairment of right ventricular function, reduced exercise capacity and a poor prognosis. Little is known about the prevalence, clinical manifestation and impact of atrial fibrillation (AF) on cardiac function in PH. In a four year single-ce...
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| description | Pulmonary hypertension (PH) is associated with progressive impairment of right ventricular function, reduced exercise capacity and a poor prognosis. Little is known about the prevalence, clinical manifestation and impact of atrial fibrillation (AF) on cardiac function in PH.
In a four year single-centre retrospective analysis 225 patients with confirmed PH of various origins were enrolled to investigate the prevalence of AF, and to assess the clinical manifestation, 6-minute walk distance, NT-proBNP levels, echocardiographic parameters and hemodynamics obtained by right heart catheterization in PH with AF.
AF was prevalent in 31.1%. In patients with PH and AF, parameters of clinical deterioration (NYHA/WHO functional class, 6-minute walk distance, NT-proBNP levels) and renal function were significantly compromised compared to patients with PH and sinus rhythm (SR). In the total PH cohort and in PH not related to left heart disease occurrence of AF was associated with an increase of right atrial pressure (RAP) and right atrial dilatation. While no direct association was found between pulmonary artery pressure (PAP) and AF in these patients, right ventricular function was reduced in AF, indicating more advanced disease. In PH due to left heart failure the prevalence of AF was particularly high (57.7% vs. 23.1% in other forms of PH). In this subgroup, left atrial dilatation, increase of pulmonary capillary wedge pressure, PAP and RAP were more pronounced in AF than in SR, suggesting that more marked backward failure led to AF in this setting.
PH is associated with increased prevalence of AF. Occurrence of AF in PH indicates clinical deterioration and more advanced disease. |
| doi_str_mv | 10.1371/journal.pone.0033902 |
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In a four year single-centre retrospective analysis 225 patients with confirmed PH of various origins were enrolled to investigate the prevalence of AF, and to assess the clinical manifestation, 6-minute walk distance, NT-proBNP levels, echocardiographic parameters and hemodynamics obtained by right heart catheterization in PH with AF.
AF was prevalent in 31.1%. In patients with PH and AF, parameters of clinical deterioration (NYHA/WHO functional class, 6-minute walk distance, NT-proBNP levels) and renal function were significantly compromised compared to patients with PH and sinus rhythm (SR). In the total PH cohort and in PH not related to left heart disease occurrence of AF was associated with an increase of right atrial pressure (RAP) and right atrial dilatation. While no direct association was found between pulmonary artery pressure (PAP) and AF in these patients, right ventricular function was reduced in AF, indicating more advanced disease. In PH due to left heart failure the prevalence of AF was particularly high (57.7% vs. 23.1% in other forms of PH). In this subgroup, left atrial dilatation, increase of pulmonary capillary wedge pressure, PAP and RAP were more pronounced in AF than in SR, suggesting that more marked backward failure led to AF in this setting.
PH is associated with increased prevalence of AF. Occurrence of AF in PH indicates clinical deterioration and more advanced disease.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0033902</identifier><identifier>PMID: 22439013</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Atrial fibrillation ; Atrial Fibrillation - complications ; Atrial Fibrillation - physiopathology ; Atrial Function, Left ; Beta blockers ; Capillary pressure ; Cardiac arrhythmia ; Cardiac Catheterization ; Cardiology ; Care and treatment ; Catheterization ; Classification ; Coronary artery disease ; Echocardiography ; Exercise Test ; Female ; Fibrillation ; Heart ; Heart attacks ; Heart diseases ; Heart failure ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Pulmonary - complications ; Hypertension, Pulmonary - physiopathology ; Internal medicine ; Male ; Medical records ; Medical research ; Medicine ; Middle Aged ; Mortality ; Natriuretic Peptide, Brain - blood ; Patients ; Peptide Fragments - blood ; Prognosis ; Pulmonary arteries ; Pulmonary artery ; Pulmonary hypertension ; Renal function ; Retrospective Studies ; Sinus ; Sinuses ; Studies ; Task forces ; Ventricle ; Ventricular Function, Left</subject><ispartof>PloS one, 2012-03, Vol.7 (3), p.e33902-e33902</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Rottlaender et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Rottlaender et al. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c691t-2bb5b9e9bedfcc333a4e4ae76c68f18dc0f2ec4852fd8748082a2986b5aa189a3</citedby><cites>FETCH-LOGICAL-c691t-2bb5b9e9bedfcc333a4e4ae76c68f18dc0f2ec4852fd8748082a2986b5aa189a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3306317/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3306317/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23871,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22439013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hodgson-Zingman, Denice</contributor><creatorcontrib>Rottlaender, Dennis</creatorcontrib><creatorcontrib>Motloch, Lukas J</creatorcontrib><creatorcontrib>Schmidt, Daniela</creatorcontrib><creatorcontrib>Reda, Sara</creatorcontrib><creatorcontrib>Larbig, Robert</creatorcontrib><creatorcontrib>Wolny, Martin</creatorcontrib><creatorcontrib>Dumitrescu, Daniel</creatorcontrib><creatorcontrib>Rosenkranz, Stephan</creatorcontrib><creatorcontrib>Erdmann, Erland</creatorcontrib><creatorcontrib>Hoppe, Uta C</creatorcontrib><title>Clinical impact of atrial fibrillation in patients with pulmonary hypertension</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Pulmonary hypertension (PH) is associated with progressive impairment of right ventricular function, reduced exercise capacity and a poor prognosis. Little is known about the prevalence, clinical manifestation and impact of atrial fibrillation (AF) on cardiac function in PH.
In a four year single-centre retrospective analysis 225 patients with confirmed PH of various origins were enrolled to investigate the prevalence of AF, and to assess the clinical manifestation, 6-minute walk distance, NT-proBNP levels, echocardiographic parameters and hemodynamics obtained by right heart catheterization in PH with AF.
AF was prevalent in 31.1%. In patients with PH and AF, parameters of clinical deterioration (NYHA/WHO functional class, 6-minute walk distance, NT-proBNP levels) and renal function were significantly compromised compared to patients with PH and sinus rhythm (SR). In the total PH cohort and in PH not related to left heart disease occurrence of AF was associated with an increase of right atrial pressure (RAP) and right atrial dilatation. While no direct association was found between pulmonary artery pressure (PAP) and AF in these patients, right ventricular function was reduced in AF, indicating more advanced disease. In PH due to left heart failure the prevalence of AF was particularly high (57.7% vs. 23.1% in other forms of PH). In this subgroup, left atrial dilatation, increase of pulmonary capillary wedge pressure, PAP and RAP were more pronounced in AF than in SR, suggesting that more marked backward failure led to AF in this setting.
PH is associated with increased prevalence of AF. Occurrence of AF in PH indicates clinical deterioration and more advanced disease.</description><subject>Aged</subject><subject>Atrial fibrillation</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Function, Left</subject><subject>Beta blockers</subject><subject>Capillary pressure</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Catheterization</subject><subject>Cardiology</subject><subject>Care and treatment</subject><subject>Catheterization</subject><subject>Classification</subject><subject>Coronary artery disease</subject><subject>Echocardiography</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary - complications</subject><subject>Hypertension, Pulmonary - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rottlaender, Dennis</au><au>Motloch, Lukas J</au><au>Schmidt, Daniela</au><au>Reda, Sara</au><au>Larbig, Robert</au><au>Wolny, Martin</au><au>Dumitrescu, Daniel</au><au>Rosenkranz, Stephan</au><au>Erdmann, Erland</au><au>Hoppe, Uta C</au><au>Hodgson-Zingman, Denice</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical impact of atrial fibrillation in patients with pulmonary hypertension</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-03-16</date><risdate>2012</risdate><volume>7</volume><issue>3</issue><spage>e33902</spage><epage>e33902</epage><pages>e33902-e33902</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Pulmonary hypertension (PH) is associated with progressive impairment of right ventricular function, reduced exercise capacity and a poor prognosis. Little is known about the prevalence, clinical manifestation and impact of atrial fibrillation (AF) on cardiac function in PH.
In a four year single-centre retrospective analysis 225 patients with confirmed PH of various origins were enrolled to investigate the prevalence of AF, and to assess the clinical manifestation, 6-minute walk distance, NT-proBNP levels, echocardiographic parameters and hemodynamics obtained by right heart catheterization in PH with AF.
AF was prevalent in 31.1%. In patients with PH and AF, parameters of clinical deterioration (NYHA/WHO functional class, 6-minute walk distance, NT-proBNP levels) and renal function were significantly compromised compared to patients with PH and sinus rhythm (SR). In the total PH cohort and in PH not related to left heart disease occurrence of AF was associated with an increase of right atrial pressure (RAP) and right atrial dilatation. While no direct association was found between pulmonary artery pressure (PAP) and AF in these patients, right ventricular function was reduced in AF, indicating more advanced disease. In PH due to left heart failure the prevalence of AF was particularly high (57.7% vs. 23.1% in other forms of PH). In this subgroup, left atrial dilatation, increase of pulmonary capillary wedge pressure, PAP and RAP were more pronounced in AF than in SR, suggesting that more marked backward failure led to AF in this setting.
PH is associated with increased prevalence of AF. Occurrence of AF in PH indicates clinical deterioration and more advanced disease.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22439013</pmid><doi>10.1371/journal.pone.0033902</doi><tpages>e33902</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2012-03, Vol.7 (3), p.e33902-e33902 |
| issn | 1932-6203 1932-6203 |
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| subjects | Aged Atrial fibrillation Atrial Fibrillation - complications Atrial Fibrillation - physiopathology Atrial Function, Left Beta blockers Capillary pressure Cardiac arrhythmia Cardiac Catheterization Cardiology Care and treatment Catheterization Classification Coronary artery disease Echocardiography Exercise Test Female Fibrillation Heart Heart attacks Heart diseases Heart failure Hemodynamics Humans Hypertension Hypertension, Pulmonary - complications Hypertension, Pulmonary - physiopathology Internal medicine Male Medical records Medical research Medicine Middle Aged Mortality Natriuretic Peptide, Brain - blood Patients Peptide Fragments - blood Prognosis Pulmonary arteries Pulmonary artery Pulmonary hypertension Renal function Retrospective Studies Sinus Sinuses Studies Task forces Ventricle Ventricular Function, Left |
| title | Clinical impact of atrial fibrillation in patients with pulmonary hypertension |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-15T02%3A53%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20impact%20of%20atrial%20fibrillation%20in%20patients%20with%20pulmonary%20hypertension&rft.jtitle=PloS%20one&rft.au=Rottlaender,%20Dennis&rft.date=2012-03-16&rft.volume=7&rft.issue=3&rft.spage=e33902&rft.epage=e33902&rft.pages=e33902-e33902&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0033902&rft_dat=%3Cgale_plos_%3EA477077356%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1324439893&rft_id=info:pmid/22439013&rft_galeid=A477077356&rft_doaj_id=oai_doaj_org_article_5d040aaaa665488a8032b928a78c196f&rfr_iscdi=true |