Russian Heart Failure Journal 2008year Atrial fibrillation in patients with CHF is associated with impaired renal function


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2008/

Atrial fibrillation in patients with CHF is associated with impaired renal function

Shutov A.M., Serov V.A., Kurzina E.V., Shevchenko S.V., Gerdt A.M., Serova D.V.

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Urgency. Recent studies have shown that renal function is an important predictor in CHF. Atrial fibrillation (AF) is a type of arrhythmia commonly observed in practice, particularly in patients with CHF. However a possible effect of impaired renal function on development of AF is not studied. Aim. To specify the relationship between impaired renal function and AF in patients with CHF. Materials and methods. 340 patients (200 men and 140 women; mean age 58±13 years) were evaluated. CHF was induced by AH in 44 (13 %) patients; IHD – in 112 (33 %) patients; and combination of AH and IHD – in 184 (54 %) patients. 112 (33 %) patients had FC I CHF, 177 (52 %) patients had FC II CHF, 34 (10 %) patients had FC III CHF, and 17 (5 %) patients had FC IV CHF. Glomerular filtration rate (GFR) was calculated using the MDRD formula. 30 patients had paroxysmal/persistent AF and 27 patients had constant AF. Results. Mean GFR was 68.8 ± 20.9 mL/min/1.73 m2 (19.2–149.7 mL/min/1.73 m2); 114 (34 %) patients had GFR <60 mL/min/1.73 m2. LV EF was 56.9 ± 10.5 %. Systolic dysfunction was detected in 90 (26 %) patients. Patients with impaired renal function had a larger left ventricular (LV) diameter than patients with preserved renal function (GFR <60 mL/min/1.73 m2 – 42.2 ± 5.8 mm vs. GFR ≥60 mL/min/1.73 m2 – 40.1± 5.4 mm, respectively, p =0.001). GFR was lower in patients with AF than without AF (58.8 ± 14.2 mL/min/1.73 m2 vs. 69.1±18.8 mL/min/1.73 m2, respectively; p <0.001). Logistic regression analysis showed that chronic renal disease (CRD) (RR: 2.3; 95% confidence interval: 1.2–4.3) and CHF FC (RR: 1.8; 95% CI: 1.0–3.1) were independently associated with impaired renal function, which can be probably attributed to the effect of CRD factors on heart remodeling.
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