title: Frequency of Left Ventricular Hypertrophy in Non-Valvular Atrial Fibrillation.
abstract: Left ventricular hypertrophy (LVH) is significantly related to adverse clinical outcomes in patients at high risk of cardiovascular events. In patients with atrial fibrillation (AF), data on LVH, that is, prevalence and determinants, are inconsistent mainly because of different definitions and heterogeneity of study populations. We determined echocardiographic-based LVH prevalence and clinical factors independently associated with its development in a prospective cohort of patients with non-valvular (NV) AF. From the "Atrial Fibrillation Registry for Ankle-brachial Index Prevalence Assessment: Collaborative Italian Study" (ARAPACIS) population, 1,184 patients with NVAF (mean age 72 ± 11 years; 56% men) with complete data to define LVH were selected. ARAPACIS is a multicenter, observational, prospective, longitudinal on-going study designed to estimate prevalence of peripheral artery disease in patients with NVAF. We found a high prevalence of LVH (52%) in patients with NVAF. Compared to those without LVH, patients with AF with LVH were older and had a higher prevalence of hypertension, diabetes, and previous myocardial infarction (MI). A higher prevalence of ankle-brachial index ≤0.90 was seen in patients with LVH (22 vs 17%, p = 0.0392). Patients with LVH were at significantly higher thromboembolic risk, with CHA2DS2-VASc ≥2 seen in 93% of LVH and in 73% of patients without LVH (p <0.05). Women with LVH had a higher prevalence of concentric hypertrophy than men (46% vs 29%, p = 0.0003). Logistic regression analysis demonstrated that female gender (odds ratio [OR] 2.80, p <0.0001), age (OR 1.03 per year, p <0.001), hypertension (OR 2.30, p <0.001), diabetes (OR 1.62, p = 0.004), and previous MI (OR 1.96, p = 0.001) were independently associated with LVH. In conclusion, patients with NVAF have a high prevalence of LVH, which is related to female gender, older age, hypertension, and previous MI. These patients are at high thromboembolic risk and deserve a holistic approach to cardiovascular prevention.
authors.affiliation: University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza-University of Rome, Rome, Italy. Electronic address: marco.proietti@uniroma1.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Proietti
authors.affiliation: Pulmonary Hypertension Center, Thorax Clinic, University of Heidelberg, Heidelberg, Germany.
authors.forename: Alberto Maria
authors.initials: AM
authors.lastname: Marra
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Eliezer Joseph
authors.initials: EJ
authors.lastname: Tassone
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, Department of Medicine, University of Perugia, Perugia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Vuono
authors.affiliation: Biomedical Department of Internal Medicine, University of Palermo, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Corrao
authors.affiliation: First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gobbi
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perticone
authors.affiliation: First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Gino Roberto
authors.initials: GR
authors.lastname: Corazza
authors.affiliation: I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza-University of Rome, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Basili
authors.affiliation: University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.affiliation: I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza-University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
authors.affiliation: I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza-University of Rome, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Raparelli
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D014463:Ultrasonography