Inflammation and fibrosis markers, including hsCRP (OR 5.28, p=0.001) and TGF-Beta (OR 2.95, p=0.001), were significantly associated with atrial fibrillation in hypertensive patients with HFpEF.
Case-Control (n=149)
Are inflammation, fibrosis, and left ventricular diastolic dysfunction associated with atrial fibrillation in hypertensive patients with HFpEF?
Inflammation, fibrosis, and left ventricular diastolic dysfunction represent independent risk factors for the development of atrial fibrillation in hypertensive patients with HFpEF.
Odds Ratio: 5.28
p-value: p=0.001
Objective: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and frequently coexists with heart failure (HF). Of particular interest is development of AF in hypertensive patients with HF with preserved ejection fraction (HFpEF). Hypertension substantially increases the risk of AF and represents a major contributor to cardiac remodeling. AF is associated with atrial structural and electrical remodeling, which may be driven by inflammatory and fibrotic processes. The aim of this study was to identify potential factors contributing to the development of AF in patients with HFpEF. Design and method: This retrospective study included 78 hypertensive patients with HFpEF and non-valvular paroxysmal/persistent AF (mean age 58.6±7.4 years) who had undergone successful cardioversion. A control group consisted of 71 hypertensive HFpEF patients. In addition to standard clinical evaluation, all patients underwent echocardiography, 24-hour Holter and blood pressure ambulatory monitoring. Inflammation markers, including high-sensitivity C-reactive protein (hsCRP) and interleukin-6, as well as the fibrosis marker transforming growth factor-Beta (TGF-Beta), were measured. Statistical analysis was performed using SPSS software with logistic regression analysis and calculation of odds ratios (ORs). Results: Compared with HFpEF hypertensive patients without AF, those with AF demonstrated significantly higher ORs for age (2.18 vs. 1.06; p=0.05), left atrial diameter (2.96 vs. 1.00; p=0.017), and episodes of hypertensive crises (3.17 vs. 1.26; p=0.001). Significant increases were also observed in markers of atrial electrical remodeling, including maximum P-wave duration (OR 3.74 vs. 1.16; p=0.001) and P-wave dispersion (OR 3.97 vs 1.56; p=0.001). Parameters of left ventricular diastolic dysfunction were significantly associated with AF, including deceleration time (OR 2.86 vs. 0.99; p=0.01) and isovolumetric relaxation time (OR 3.94 vs. 1.09; p=0.016). Moreover, inflammatory markers were markedly elevated in the AF group, with higher odds ratios for hsCRP (OR 5.28 vs. 1.17; p=0.001) and interleukin-6 (OR 4.67 vs. 1.28; p=0.001), as well as for the fibrosis marker TGF-Beta (OR 2.95 vs. 1.08; p=0.001), compared with the control group. Conclusions: Multifactorial analysis demonstrated that inflammation and fibrosis, together with left ventricular diastolic dysfunction, represent additional independent risk factors for the development of AF in hypertensive patients with HFpEF.
Hazarapetyan et al. (Fri,) conducted a case-control in Hypertension with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (n=149). Inflammation and fibrosis markers (hsCRP, IL-6, TGF-Beta) vs. Hypertensive HFpEF patients without AF was evaluated on Association of high-sensitivity C-reactive protein (hsCRP) with atrial fibrillation (OR 5.28, p=0.001). Inflammation and fibrosis markers, including hsCRP (OR 5.28, p=0.001) and TGF-Beta (OR 2.95, p=0.001), were significantly associated with atrial fibrillation in hypertensive patients with HFpEF.