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Title: Renal disease and left atrial remodeling predict atrial fibrillation in patients with cardiovascular risk factors. Author: Sciacqua A, Perticone M, Tripepi G, Miceli S, Tassone EJ, Grillo N, Carullo G, Sesti G, Perticone F. Journal: Int J Cardiol; 2014 Jul 15; 175(1):90-5. PubMed ID: 24836687. Abstract: OBJECTIVES: In this prospective population-based study, we tested the possible interaction between chronic kidney disease (CKD) and left atrium volume index (LAVI) in predicting incident atrial fibrillation (AF). METHODS: We enrolled 3549 Caucasian subjects, 1829 men and 1720 women, aged 60.7 ± 10.6 years, without baseline AF and thyroid disorders. Echocardiographic left ventricular mass and LAVI were measured. Renal function was calculated by estimated glomerular filtration rate (e-GFR). To test the effect of some clinical confounders on incident AF, we constructed different models including clinical and laboratory parameters. AF diagnosis was made by standard electrocardiogram or 24-h ECG-Holter, hospital discharge diagnoses, and by the all-clinical documentation. RESULTS: During the follow-up (53.3 ± 18.1 months), 546 subjects developed AF (4.5 events/100 patient-years). Progressors to AF were older, had a higher body mass index, blood pressure, LDL-cholesterol, glucose, cardiac mass, and LAVI, and had lower e-GFR. Hypertension, metabolic syndrome, diabetes, cardiac hypertrophy and CKD were more common among AF cases than controls. In the final Cox regression model, variables that remained significantly associated with AF were: cardiac hypertrophy (HR=1.495, 95% CI=1.215-1.841), renal disease (HR=1.528, 95% CI=1.261-1.851), age (HR=1.586, 95% CI=1.461-1.725) and LAVI (HR=2.920, 95% CI=2.426-3.515). The interaction analysis demonstrated a synergic effect between CKD and cardiac hypertrophy (HR=4.040, 95% CI=2.661-6.133), as well as between CKD and LAVI (HR=4.875, 95% CI=2.699-8.805). The coexistence of all three subclinical organ damages significantly increases the arrhythmic risk (HR=7.185, 95% CI=5.041-10.240). CONCLUSIONS: Our data demonstrate that LAVI and CKD significantly interact in a synergic manner in increasing AF risk.[Abstract] [Full Text] [Related] [New Search]