| ObjectiveWe aimed to investigate the clinical features,electrocardiographic characteristics and the prevalence and predictors of atrial fibrillation in patients with dilated cardiomyopathy(DCM)and hypertrophic cardiomyopathy(HCM),which may extend the degree of attention of clinicians to DCM and HCM complicated with atrial fibrillation(AF)and provide evidence for clinical diagnosis and treatment.MethodsWe retrospectively collected 230 patients who were hospitalized in the Second Hospital of Tianjin Medical University from February 2007 to December 2017 and were discharged and diagnosed with DCM and HCM and we recorded the clinical features,libratory tests,electrocardiographic and echocardiographic characteristics.There were 174 patients with DCM,136 males and 38 females;56 patients with HCM,including 13 of obstructive hypertrophic cardiomyopathy(HOCM),33 of nonobstructive hypertrophic cardiomyopathy(HNCM)and 10 of apical hypertrophic cardiomyopathy(AHCM),37 males and 19 females.According to the clinical data collected from patients,clinical features,electrocardiographic characteristics,prevalence of atrial fibrillation(AF)and predictors of AF in patients with DCM and HCM were analyzed,and the differences between the groups were explored.Results1.A total of 230 patients with DCM and HCM were enrolled,including 173 males(75.2%)and 57 females(24.8%),with a male to female ratio of 3.04:1.The average age of the patients was 56.4±12.4 years.Patients in the DCM group had the highest prevalence of hypertension(n=83,47.7%),followed by atrial fibrillation(n=54,31.0%),coronary artery disease(n=42,24.1%),diabetes(n=33,19.0%),stroke(n=17,9.8%),and peripheral vascular diseases were least(n=7,4.0%).Patients with HCM also had the highest proportion of previous illnesses with hypertension(n=30,53.6%),followed by atrial fibrillation(n=21,37.5%)and coronary artery disease(n=21,37.5%),stroke(n=6,10.7%),diabetes(n=3,5.4%),no peripheral vascular disease.2.A total of 54 patients(31.0%)had DCM combined with atrial fibrillation,including 43 males(79.6%),11 females(20.4%),26 with anticoagulant therapy(14.9%);There were 21(37.5%)HCM patients with atrial fibrillation,included 13 males(61.9%),8 females(38.1%),and 6 with anticoagulant therapy(10.7%).3.Logistic regression analysis concluded that age(OR=1.037;95%CI=1.007-1.067,P=0.015),diabetes(OR=0.335;95%CI=0.122-0.923,P=0.034),and BUN(OR= 1.123;95% CI=1.028-1.226,P=0.010),RDW-cv(OR=1.056;95%CI=1.014-1.099,P=0.009),QRS(OR=0.976;95%CI=0.960-0.993,P=0.005)and QTc(OR=1.007;95% CI=1.001-1.013,P=0.049)were associated with AF in DCM patients,but in a multivariate model,only age(OR=1.079;95%CI=1.020-1.141,P=0.008)and BUN(OR=1.211;95%CI=1.021-1.435,P=0.028)were the independent risk factors for AF.The CHA2DS2-VASc score of 5-9 points(OR=13.000;95%CI=1.109-152.351,P=0.041),BUN(OR=1.431;95%CI=1.042-1.966,P=0.027),LAD?47mm(OR=32.000;95%CI=5.660-180.931,P < 0.001)and QTc interval(OR=1.067;95%CI=1.018-1.118,P=0.007)were associated with AF in patients with HCM.In addition,a multivariate analysis revealed LAD?47mm(OR=29.810;95%CI=1.667-533.052,P=0.021)was an independent risk factor for AF in HCM patients.Conclusion1.The patients with DCM and HCM had a small male preponderance and were mainly in middle age.The most common comorbidity was hypertension,following by atrial fibrillation.2.The proportion of HCM patients complicated with AF was higher than that of DCM patients complicated with AF.The frequency of males was higher than that of females in patients with either DCM or HCM.A higher frequency of anticoagulant therapy was found in DCM patients than in HCM patients.3.In logistic regression analysis,age and BUN were independent risk factors for AF in patients with DCM.And LAD?47mm was an independent risk factor for AF in patients with HCM. |
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