Introduction: Renal dysfunction in heart failure (HF) patients is associated with poor outcomes. Reduced cardiac index (CI) and right atrial pressure (RAP) are postulated to be a contributor the renal dysfunction. This study aimed to investigate the relationship between the estimated glomerular filtration rate (eGFR) and the pulmonary artery catheterization (PAC) results. Patients and Method: Hospitalized advanced HF patients, between 2016-2020 PAC performed included in the study. Renal dysfunction was defined as eGFR<60 ml/min/1.73 m 2. We evaluated the correlation and the linear regression models of hemodynamics with eGFR. Results: 181 patients were included in the study, and the mean left ventricular ejection fraction (LVEF) was 20.9±3.7%, the mean eGFR was 79.8±25.4 ml/min/1.73 m 2, and 22.7% of patients had eGFR lower than 60 ml/min/1.73 m 2. CI (1.85±0.72; 1.84±0.64; p=0.47, respectively) and RAP (13.1±6.6; 13.7±6.8; p=0.61,respectively) was not significantly associated with renal dysfunction in HF patients. In the multivariable model, smoking history, AF, body mass index (BMI) revealed negative relation with eGFR, continuing ACEi or ARB therapy, and pulmonary artery capacitance index(PAC-i) were positively related variables with eGFR (p<0.0001). eGFR was not significantly different in distinct tricuspid regurgitation severities (p=0.67); however, eGFR was non-significantly higher in patients with moderate tricuspid regurgitation. In patients with moderate tricuspid regurgitation, eGFR had an inverse relationship with the RVSW-i and TRVP-i. Conclusion: These results indicate that CI or RAP is not the primary driver for eGFR. PAC-i and continuing ACEi or ARB positively, AF, smoking history, and BMI were negatively related factors for reduced eGFR.

Abstract Aim: The prevalence of atrial fibrillation (AF) in patients with myocardial infarction (MI) ranges widely and has been reported to be as high as 21%. However, the demographic, clinical, and angiographic characteristics of AF patients with de novo MI is unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. Methods: The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to their presenting cardiac rhythm. Results: A total of 1793 patients were screened and 1626 were included in the study. Mean age was 61.5 (12.5) years. 70.7% of patients were men. Prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p<0.001] than non-AF patients. The proportion of women to men in the AF group was also higher than in the non-AF group (43.1% vs. 28.7%, p=0.027). Dramatically, the minority of patients were previously diagnosed with AF (14 patients, 27.4%) and only 1 out of every 5 AF patients (10 patients, 19.6%) was using oral anticoagulants (OAC). Conclusions: AF prevalence in patients presenting with de novo MI was lower than reported in previous studies. The majority of AF patients did not have any knowledge of their arrhythmia and were not undergoing OAC therapy at admission, emphasizing the vital role of successful diagnostic strategies, patient education, and implementations for guideline adaptation.