New Onset Heart Failure Presents with Advanced, Global Cardiac
Remodeling when Associated with Atrial Fibrillation
Abstract
Introduction: This study aimed to evaluate the extent of baseline
cardiac remodeling present in patients with new-onset cardiomyopathy
(CM) with and without atrial fibrillation (AF). AF concurrent with heart
failure is associated with increased morbidity and mortality. There is
limited research comparing the extent of cardiac remodeling present in
patients with new-onset CM associated with AF (AF-CM group) to that
present in patients with new-onset CM without any concomitant or
antecedent dysrhythmia (CM group). Methods and Results: 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. 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. Conclusion: Patients with new-onset CM
with AF had greater global cardiac remodeling at presentation than those
with CM not associated with AF.