Relationship between atrial fibrillation and a liver fibrogenesis marker in patients with acute heart failure

医学 心房颤动 内科学 心力衰竭 窦性心律 临床终点 心脏病学 置信区间 入射(几何) 相伴的 危险系数 胃肠病学 随机对照试验 光学 物理
作者
Ryota Miyamoto,Keisuke Nagao,Kenichi Matsuto,Reo Hata,Yoshiaki Kawase,Shiori Maruichi‐Kawakami,Kenji Aida,Kazushige Kadota,Yukihito Sato,Tsukasa Inada
出处
期刊:International Journal of Cardiology [Elsevier BV]
卷期号:374: 51-57 被引量:1
标识
DOI:10.1016/j.ijcard.2023.01.001
摘要

Hemodynamic disturbance in heart failure (HF) induces extra-cardiac organ injury. Atrial fibrillation (AF) is common in patients with HF. The relationship between AF and organ injury in HF remains unclear. We investigated the relationship between AF and the liver fibrosis marker, type IV collagen 7S (P4NP 7S) in patients with HF.From a pooled dataset of 3 observational cohorts of hospitalized HF, 720 patients in whom P4NP 7S was measured before discharge were included. Median P4NP 7S were 5.1, 5.3, and 6.2 ng/mL in the sinus rhythm (SR) (n = 368), paroxysmal AF (n = 67), and persistent AF (n = 285) groups, respectively (P < 0.001). In the multiple linear regression analysis, the significant association with P4NP 7S was found for persistent AF (P < 0.001). The cumulative 1-year incidence of the primary composite endpoint of cardiac death and HF hospitalization were 27.6, 24.1, and 34.5% in the SR, paroxysmal AF, and persistent AF groups, respectively (Log-rank P = 0.07) and 25.3 and 34.5% in the low (below median) and high P4NP 7S groups, respectively (Log-rank P = 0.005). The adjusted risks of persistent AF versus SR and high P4NP 7S versus low P4NP 7S for the primary endpoint were 1.38 (95% confidence interval 1.02-1.89) and 1.52 (1.14-2.03), respectively. When patients were divided based on a combination of AF and P4NP 7S, concomitant persistent AF and high P4NP 7S portended a dismal prognosis.AF is associated with an increase in the liver fibrosis marker. Co-presence of persistent AF and P4NP 7S may portend adverse clinical outcomes.
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