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Atrial Fibrilation: A Negative Prognostic Factor for Patients with Dilated Cardiomyopathy

Abstract

Rus Marius

The dilated cardiomyopathy (DCM) is a myocardial disease characterized by a dilated left ventricle (LV) and an impaired systolic function of the left ventricle. Most common secondary DCM is ischemic, but severe uncorrected valvulopathies also can lead to the enlargement of LV due to volume or pressure overload. In almost half of DCM patients, the etiology remains unknown. The dilated cardiomyopathy will lead to a progressive, irreversible heart failure, despite the big progressions made in both medical treatment and heart assisting devices. Atrial fibrillation (AF) is a commonly seen arrhythmia in patients with dilated cardiomyopathy, due to the structural modifications of left atrial myocytes.

The objective of this study is to observe the impact of the association between dilated cardiomyopathy and atrial fibrillation on the severity of heart failure. For this purpose, 139 patients were taken into observation, from the moment of their emergency hospitalization for heart failure, and were followed for a year. At baseline, 64 patients (46.04%) had permanent atrial fibrillation, and the rest of 75 (53.96%) were in sinus rhythm. From all patients, 70.5% (98) were men, the incidence of DCM being greater in men than women. Patients with AF were older, required prolonged hospitalization, had Lower Left Ventricle Ejection Fraction (LVEF), greater New York Heart Association (NYHA) class and more frequently associated right ventricle disfunction (RV).

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