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The predictors of atrial fibrillation in patients with rheumatic mitral stenosis

Year 2014, Volume: 5 Issue: 3, 435 - 440, 01.09.2014
https://doi.org/10.5799/ahinjs.01.2014.03.0434

Abstract

Objective: In this study we aimed to investigate the relationship between the presence of atrial fibrillation (AF) and serum albumin levels which is a negative acute phase protein. Methods: This study is single-center and has a retrospective design. We included patients with a diagnosis of rheumatic mitral stenosis (RMS) and having serum albumin levels between 2011 and 2014. Then the patients were divided into two groups according to presence of AF. Clinical and laboratory data of these two groups were compared. Results: The study included 74 patients having the inclusion criteria. Seventy seven percent of patients were female, mean age was 44±12 years. Atrial fibrillation was detected in 34% of the patients. Hypertension presence, age, left atrial diameter, creatinine, C-reactive protein were higher in AF group while serum albumin, left ventricular ejection fraction and mean transmitral gradient was significantly lower. Multivariate logistic regression analysis showed that aging, lower albumin and anemia (respectively, odds ratio [OR]: 1.124, 95% confidence interval [CI], [1.049-1.205], OR: 0.022, 95% CI; [0.002-0.268] and OR: 5.941, 95% CI; [1.031-34.222]) were found to be independent predictors of AF presence. Conclusion: Lower serum albümin levels, aging and anemia were associated with the presence of AF in patients with RMD. Low albümin levels can be a surrogate marker of increased inflammation and may serve as a risk factor for AF development. J Clin Exp Invest 2014; 5 (3): 435-440

References

  • Marijon E, Mirabel M, Celermajer DS, Jouven X. Rheu- matic heart disease. Lancet 2012; 379: 953–964.
  • Rajamannan NM, Antonini-Canterin F, Moura L, et al. Medical therapy for rheumatic heart disease: is it time to be proactive rather than reactive? Indian Heart J 2009;61:14–23.
  • Vahanian A, Alfieri O, Andreotti F, et al. Joint Task Force on the Management of Valvular Heart Disease of the European Society of C, European Association for Cardio-Thoracic S Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012;33:2451-2496.
  • Chandrashekhar Y, Westaby S, Narula J. Mitral steno- sis. Lancet 2009;374:1271–1283.
  • Pourafkari L, Ghaffari S, Bancroft GR, Tajlil A, Nader ND. Factors associated with atrial fibrillation in rheu- matic mitral stenosis. Asian Cardiovasc Thorac Ann 2014. DOI: 10.1177/0218492314530134.
  • Whitlock RP, Sun JC, Fremes SE, et al. American Col- lege of Chest Physicians. Antithrombotic and throm- bolytic therapy for valvular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: Ameri- can College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012;141:576-600.
  • Don BR, Kaysen G. Serum Albumin: Relationship to Inflammation and nutrition. Seminars in Dialysis 2004;17; 432–437
  • Chojkier M. Inhibition of albumin synthesis in chronic diseases: molecular mechanisms. J Clin Gastroen- terol 2005;39:143-146.
  • Chang CJ, Hsu LA, Chiang CW, et al. Percutaneous transvenous mitral valvulotomy normalizes elevated circulating levels of tumor necrosis factor-alpha and interleukin-6 in mitral stenosis with heart failure. Am J Cardiol 2003;91:1018–1020.
  • Guilherme L, Cury P, Demarchi LM, et al. Rheumatic heart disease: proinflammatory cytokines play a role in the progression and maintenance of valvular le- sions. Am J Pathol 2004;165:1583-1591.
  • Golbasi Z, Ucar O, Keles T, et al. Increased levels of high sensitive C-reactive protein in patients with chronic rheumatic valve disease: evidence of ongoing inflammation. Eur J Heart Fail 2002;4:593-595.
  • Davutoglu V, Celik A, Aksoy M. Contribution of select- ed serum inflammatory mediators to the progression of chronic rheumatic valve disease, subsequent valve calcification and NYHA functional class. J Heart Valve Dis 2005;14:251-256.
  • Polat N, Yıldız A, Yuksel M, et al. Association of neu- trophil-lymphocyte ratio with the presence and severi- ty of rheumatic mitral valve stenosis. Clin Appl Thromb Hemost 2013. DOI: 10.1177/1076029613514131
  • Cagli KE, Aras D, Topaloglu S, et al. Plasma levels of tumor necrosis factor-α and its receptors in patients with mitral stenosis and sinus rhythm undergoing per- cutaneous balloon valvuloplasty. Heart Vessels 2010; 25:131-137.
  • Quinones MA, Otto CM, Stoddard M, et al. Recom- mendations for quantification of Doppler echocardiog- raphy: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002;15:167-184.
  • Horstkotte D, Niehues R, Strauer BE. Pathomorpholog- ical aspects, aetiology and natural history of acquired mitral valve stenosis. Eur Heart J 1991;12:55-60.
  • January CT, Wann LS, Alpert JS, et al 2014 AHA/ ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American Col- lege of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014 Mar 28. pii: S0735- 1097(14)01740-9. doi: 10.1016/j.jacc.2014.03.022.
  • Hijazi Z, Oldgren J, Siegbahn A, et al. Biomark- ers in atrial fibrillation: a clinical review. Eur Heart J 2013;34:1475–1480.
  • Kornej J, Apostolakis S, Bollmann A, Lip GY. The emerging role of biomarkers in atrial fibrillation. Can J Cardiol 2013;29:1181-1193.
  • Guo Y, Lip GY, Apostolakis S. Inflammation in Atrial Fibrillation. J Am Coll Cardiol 2012;60;2263–2270.
  • Selcuk MT, Selcuk H, Maden O, et al. Relationship between inflammation and atrial fibrillation in patients with isolated rheumatic mitral stenosis. J Heart Valve Dis 2007;16:468-474.
  • Ozaydin M, Turker Y, Varol E, et al. Factors associ- ated with the development of atrial fibrillation in pa- tients with rheumatic mitral stenosis. Int J Cardiovasc Imaging 2010;26:547–552.
  • Metivier F, Marchais SJ, Guerin AP, et al. Pathophysi- ology of anaemia: focus on the heart and blood ves- sels. Nephrol Dial Transplant 2000;15:14-18.
  • Amin MG, Tighiouart H, Weiner DE, et al. Hemato- crit and left ventricular mass: the Framingham Heart study. J Am Coll Cardiol 2004;43:1276-1282.
  • Cho IJ, Mun YC, Kwon KH, Shin GJ. Effect of anemia correction on left ventricular structure and filling pres- sure in anemic patients without overt heart disease. Korean J Intern Med 2014;29:445-453.
  • Katayama T, Fujiwara N, Tsuruya Y. Factors contribut- ing to left atrial enlargement in adults with normal left ventricular systolic function. J Cardiol 2010;55:196-204.
  • Dilaveris PE, Gialafos EJ, Sideris SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135:733-738.
  • Simsek H, Gunes Y, Demir C, et al. The effects of iron deficiency anemia on p wave duration and dispersion. Clinics 2010;65:1067-1071.
  • Weiss G. Pathogenesis and treatment of anaemia of chronic disease. Blood Rev 2002;16:87-96.
  • Kurt M, İbrahim Halil Tanboğa Hİ, Aksakal E, Kara- koyun S. Relation between epicardial fat tissue and atrial fibrillation. J Clin Exp Invest 2012;3:13-17.
  • Karthikeyan G, Ananthakrishnan R, Devasenapathy N, et al. Transient, subclinical atrial fibrillation and risk of systemic embolism in patients with rheumatic mitral stenosis in sinus rhythm. Am J Cardiol 2014 doi:10.1016/j.amjcard.2014.06.016.

Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri

Year 2014, Volume: 5 Issue: 3, 435 - 440, 01.09.2014
https://doi.org/10.5799/ahinjs.01.2014.03.0434

Abstract

Amaç: Bu çalışmada romatizmal mitral darlığı (RMD) olan hastalarda negatif akut faz proteini olan serum albümin değerinin atriyal fibrilasyon (AF) varlığı ile ilişkisini araştırmayı amaçladık. Yöntemler: Tek merkezli, geriye dönük 2011-2014 tarihleri arasında RMD teşhisi konulmuş olup serum albümin değeri olan hastalar çalışmaya dahil edildi. Daha sonra hastalar AF olup olmamasına göre iki gruba ayrıldı. Bu iki grubun klinik ve laboratuar verileri karşılaştırıldı. Bulgular: Çalışmaya dahil edilme kriterlerini sağlayan 74 hasta çalışmaya alındı. Hastaların %77\'si bayan olup, yaş ortalaması 44±12 yıl saptandı. Hastaların %34\'ünde AF olduğu görüldü. Atriyal fibrilasyonu olan grupta hipertansiyon varlığı, yaş, sol atriyum çapı, kreatinin, C-reaktif protein yüksek; albümin, sol ventrikül ejeksiyon fraksiyonu ve ortalama transmitral basınç farkı belirgin olarak düşük bulundu. Çok değişkenli lojistik regresyon analizinde yaş, albümin düşüklüğü ve anemi varlığı ( sırasıyla, odds oranı [OO]:1.124, %95 güven aralığı [GA] ; [1.049-1.205], OO: 0.022, %95 GA; [0.002-0.268] ve OO: 5.941, %95 GA; [1.031-34.222]) AF varlığının bağımsız belirteçleri olduğu saptandı. Sonuç: Serum albümin düşüklüğü ile birlikte artan yaş ve anemi varlığı RMD hastalarında AF varlığıyla ilişkilidir. Albümin düşüklüğü bu hasta grubunda artmış inflamasyonun negatif belirteci olarak AF gelişimi için risk faktörü olabilir.

References

  • Marijon E, Mirabel M, Celermajer DS, Jouven X. Rheu- matic heart disease. Lancet 2012; 379: 953–964.
  • Rajamannan NM, Antonini-Canterin F, Moura L, et al. Medical therapy for rheumatic heart disease: is it time to be proactive rather than reactive? Indian Heart J 2009;61:14–23.
  • Vahanian A, Alfieri O, Andreotti F, et al. Joint Task Force on the Management of Valvular Heart Disease of the European Society of C, European Association for Cardio-Thoracic S Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012;33:2451-2496.
  • Chandrashekhar Y, Westaby S, Narula J. Mitral steno- sis. Lancet 2009;374:1271–1283.
  • Pourafkari L, Ghaffari S, Bancroft GR, Tajlil A, Nader ND. Factors associated with atrial fibrillation in rheu- matic mitral stenosis. Asian Cardiovasc Thorac Ann 2014. DOI: 10.1177/0218492314530134.
  • Whitlock RP, Sun JC, Fremes SE, et al. American Col- lege of Chest Physicians. Antithrombotic and throm- bolytic therapy for valvular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: Ameri- can College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012;141:576-600.
  • Don BR, Kaysen G. Serum Albumin: Relationship to Inflammation and nutrition. Seminars in Dialysis 2004;17; 432–437
  • Chojkier M. Inhibition of albumin synthesis in chronic diseases: molecular mechanisms. J Clin Gastroen- terol 2005;39:143-146.
  • Chang CJ, Hsu LA, Chiang CW, et al. Percutaneous transvenous mitral valvulotomy normalizes elevated circulating levels of tumor necrosis factor-alpha and interleukin-6 in mitral stenosis with heart failure. Am J Cardiol 2003;91:1018–1020.
  • Guilherme L, Cury P, Demarchi LM, et al. Rheumatic heart disease: proinflammatory cytokines play a role in the progression and maintenance of valvular le- sions. Am J Pathol 2004;165:1583-1591.
  • Golbasi Z, Ucar O, Keles T, et al. Increased levels of high sensitive C-reactive protein in patients with chronic rheumatic valve disease: evidence of ongoing inflammation. Eur J Heart Fail 2002;4:593-595.
  • Davutoglu V, Celik A, Aksoy M. Contribution of select- ed serum inflammatory mediators to the progression of chronic rheumatic valve disease, subsequent valve calcification and NYHA functional class. J Heart Valve Dis 2005;14:251-256.
  • Polat N, Yıldız A, Yuksel M, et al. Association of neu- trophil-lymphocyte ratio with the presence and severi- ty of rheumatic mitral valve stenosis. Clin Appl Thromb Hemost 2013. DOI: 10.1177/1076029613514131
  • Cagli KE, Aras D, Topaloglu S, et al. Plasma levels of tumor necrosis factor-α and its receptors in patients with mitral stenosis and sinus rhythm undergoing per- cutaneous balloon valvuloplasty. Heart Vessels 2010; 25:131-137.
  • Quinones MA, Otto CM, Stoddard M, et al. Recom- mendations for quantification of Doppler echocardiog- raphy: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002;15:167-184.
  • Horstkotte D, Niehues R, Strauer BE. Pathomorpholog- ical aspects, aetiology and natural history of acquired mitral valve stenosis. Eur Heart J 1991;12:55-60.
  • January CT, Wann LS, Alpert JS, et al 2014 AHA/ ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American Col- lege of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014 Mar 28. pii: S0735- 1097(14)01740-9. doi: 10.1016/j.jacc.2014.03.022.
  • Hijazi Z, Oldgren J, Siegbahn A, et al. Biomark- ers in atrial fibrillation: a clinical review. Eur Heart J 2013;34:1475–1480.
  • Kornej J, Apostolakis S, Bollmann A, Lip GY. The emerging role of biomarkers in atrial fibrillation. Can J Cardiol 2013;29:1181-1193.
  • Guo Y, Lip GY, Apostolakis S. Inflammation in Atrial Fibrillation. J Am Coll Cardiol 2012;60;2263–2270.
  • Selcuk MT, Selcuk H, Maden O, et al. Relationship between inflammation and atrial fibrillation in patients with isolated rheumatic mitral stenosis. J Heart Valve Dis 2007;16:468-474.
  • Ozaydin M, Turker Y, Varol E, et al. Factors associ- ated with the development of atrial fibrillation in pa- tients with rheumatic mitral stenosis. Int J Cardiovasc Imaging 2010;26:547–552.
  • Metivier F, Marchais SJ, Guerin AP, et al. Pathophysi- ology of anaemia: focus on the heart and blood ves- sels. Nephrol Dial Transplant 2000;15:14-18.
  • Amin MG, Tighiouart H, Weiner DE, et al. Hemato- crit and left ventricular mass: the Framingham Heart study. J Am Coll Cardiol 2004;43:1276-1282.
  • Cho IJ, Mun YC, Kwon KH, Shin GJ. Effect of anemia correction on left ventricular structure and filling pres- sure in anemic patients without overt heart disease. Korean J Intern Med 2014;29:445-453.
  • Katayama T, Fujiwara N, Tsuruya Y. Factors contribut- ing to left atrial enlargement in adults with normal left ventricular systolic function. J Cardiol 2010;55:196-204.
  • Dilaveris PE, Gialafos EJ, Sideris SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135:733-738.
  • Simsek H, Gunes Y, Demir C, et al. The effects of iron deficiency anemia on p wave duration and dispersion. Clinics 2010;65:1067-1071.
  • Weiss G. Pathogenesis and treatment of anaemia of chronic disease. Blood Rev 2002;16:87-96.
  • Kurt M, İbrahim Halil Tanboğa Hİ, Aksakal E, Kara- koyun S. Relation between epicardial fat tissue and atrial fibrillation. J Clin Exp Invest 2012;3:13-17.
  • Karthikeyan G, Ananthakrishnan R, Devasenapathy N, et al. Transient, subclinical atrial fibrillation and risk of systemic embolism in patients with rheumatic mitral stenosis in sinus rhythm. Am J Cardiol 2014 doi:10.1016/j.amjcard.2014.06.016.
There are 31 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Nihat Polat This is me

Mesut Aydin This is me

Abdulkadir Yildiz This is me

Murat Yuksel This is me

Yahya Islamoglu This is me

Tuba Kurt This is me

Sait Alan This is me

Nizamettin Toprak This is me

Publication Date September 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 3

Cite

APA Polat, N., Aydin, M., Yildiz, A., Yuksel, M., et al. (2014). Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri. Journal of Clinical and Experimental Investigations, 5(3), 435-440. https://doi.org/10.5799/ahinjs.01.2014.03.0434
AMA Polat N, Aydin M, Yildiz A, Yuksel M, Islamoglu Y, Kurt T, Alan S, Toprak N. Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri. J Clin Exp Invest. September 2014;5(3):435-440. doi:10.5799/ahinjs.01.2014.03.0434
Chicago Polat, Nihat, Mesut Aydin, Abdulkadir Yildiz, Murat Yuksel, Yahya Islamoglu, Tuba Kurt, Sait Alan, and Nizamettin Toprak. “Romatizmal Mitral Kapak darlığı Olan Hastalarda Atriyal Fibrilasyon öngördürücüleri”. Journal of Clinical and Experimental Investigations 5, no. 3 (September 2014): 435-40. https://doi.org/10.5799/ahinjs.01.2014.03.0434.
EndNote Polat N, Aydin M, Yildiz A, Yuksel M, Islamoglu Y, Kurt T, Alan S, Toprak N (September 1, 2014) Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri. Journal of Clinical and Experimental Investigations 5 3 435–440.
IEEE N. Polat, “Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri”, J Clin Exp Invest, vol. 5, no. 3, pp. 435–440, 2014, doi: 10.5799/ahinjs.01.2014.03.0434.
ISNAD Polat, Nihat et al. “Romatizmal Mitral Kapak darlığı Olan Hastalarda Atriyal Fibrilasyon öngördürücüleri”. Journal of Clinical and Experimental Investigations 5/3 (September 2014), 435-440. https://doi.org/10.5799/ahinjs.01.2014.03.0434.
JAMA Polat N, Aydin M, Yildiz A, Yuksel M, Islamoglu Y, Kurt T, Alan S, Toprak N. Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri. J Clin Exp Invest. 2014;5:435–440.
MLA Polat, Nihat et al. “Romatizmal Mitral Kapak darlığı Olan Hastalarda Atriyal Fibrilasyon öngördürücüleri”. Journal of Clinical and Experimental Investigations, vol. 5, no. 3, 2014, pp. 435-40, doi:10.5799/ahinjs.01.2014.03.0434.
Vancouver Polat N, Aydin M, Yildiz A, Yuksel M, Islamoglu Y, Kurt T, Alan S, Toprak N. Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri. J Clin Exp Invest. 2014;5(3):435-40.