O.S. Sychov, A.O. Borodai. Myocardial function and quality of life in patients with new-onset atrial fibrillation

The aim – to evaluate clinical, echocardiographic characteristics and quality of life in patients with new-onset atrial fibrillation (AF).

Material and methods. In prospective, cross sectional study we examined consecutive 322 patients with non-valvular AF. New-onset AF was diagnosed in 104 (32.3 %) patients. All of them were studied by transthoracic and transesophageal echocardiography. Quality of life was assessed by HeartQol questionnaire and EHRA score. In order to assess anxiety and depression we used HADS scale.

Results. Functional class NYHA III–IV was more commonly detected in patients with chronic AF 24.4 % vs 11.9 % (Р=0.02). Ejection fraction < 40 % was found in 17.3 % vs 11.1 %, Р=0.1 for patients with new onset and chronic AF respectively. Low left atrial appendage velocity < 30 cm/s was equally common 46.6 % vs 43.4 %, Р=0.6 in patients with new onset and chronic AF respectively. Left atrial appendage (LAA) thrombus was found in 6.8 % of cases with new onset AF vs 11 % of cases with chronic AF, Р=0.25. Sludge in LAA was found in 4.8 % vs 11.1 %, Р=0.07 for patients with new onset AF and chronic AF respectively. Patients with chronic AF had significantly worse physical 1.5 vs 1.8, Р=0.0006 as well as emotional 2.0 vs 2.3, Р=0.0002 components of HeartQol. Very low physical HeartQol < 1.8 was detected in chronic AF group 58.4 % vs 46.3 %, Р=0.05, but difference between emotional HeartQol < 1.8 was significant, 40 % vs 20 %, Р=0.0007 for chronic AF and new onset AF respectively. Probable anxiety with HADSA ≥ 11 was found in 12.1 % of chronic AF patients vs 5.15 % of new onset AF patients, Р=0.05. The difference of incidence of probable depression with HADSD ≥ 11, was also insignificant for groups with new onset 9.2 % vs 4.7 % for chronic AF. Conclusions. There was no differences in detection of low left atrial appendage velocity, thrombus and sludge among patients with new onset and chronic AF. The worst indices of quality of life were registered in patients with chronic AF. Difference of the incidence of anxiety and depression was insignificant between groups.

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