Newly Identified Cardiomyopathy Often Presents with Advanced, Global Cardiac Remodeling When Associated with Atrial Fibrillation

Document Type

Article

Publication Date

3-2022

Publisher

CardioFront LLC

Source Publication

Journal of Atrial Fibrillation & Electrophysiology (JAFIB-EP)

Source ISSN

1941-6911

Abstract

Background: AF concurrent with cardiomyopathy is associated with increased morbidity and mortality. There is limited research comparing the extent of cardiac remodeling present in patients with new-onset cardiomyopathy (CM) associated with atrial fibrillation (AF) (AF-CM group) to that present in patients with new-onset CM without any concomitant or antecedent dysrhythmia (CM group). This study aimed to evaluate the extent of baseline cardiac remodeling present in patients with new-onset CM with and without AF. This review does not attempt to address the gap in knowledge of the mechanisms or the temporal relationship of AF-associated remodeling in patients with CM and AF.

Hypothesis: AF has effects on the heart at structural, functional, and electrophysiological levels. Thus, we hypothesized that AF-CM will have more pan-myocardial chamber remodeling compared to isolated CM.

Methods: Patients with a left ventricular ejection fraction ≤40% without a prior history of CM were identified from our healthcare system’s electronic medical records for the period of January 1, 2012 to September 30, 2016. Those with an antecedent or concomitant diagnosis of AF comprised the AF-CM group, and those with no prior dysrhythmia comprised the CM group. The AF-CM group (n=196) was compared with the CM group (n=197). The groups were controlled for left ventricular ejection fraction.

Results: Patients in the AF-CM group had more left atrial, right atrial, and right ventricular remodeling, more advanced right ventricular systolic dysfunction, and increased severity of both tricuspid and mitral regurgitation at presentation than the CM group.

Conclusions: Patients with newly – identified CM with AF had greater global cardiac remodeling at presentation than those with CM not associated with AF.

Comments

Journal of Atrial Fibrillation & Electrophysiology (JAFIB-EP), Vol. 15, No. 2 (March 2022): 22-28. Publisher link.

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