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Incidence, predictors, and clinical course of atrial tachyarrhythmias in patients with pulmonary hypertension

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

The prevalence and predictors of atrial tachyarrhythmias (ATa) in patients with pulmonary hypertension (PH) is less well understood.

Methods

We performed a retrospective study including 311 patients with PH, confirmed by right heart catheterization in our center between 2007 and 2011. Baseline characteristics, clinical, echocardiographic, and hemodynamic data were collected and compared between patients with and without ATa.

Results

The mean age was 61 ± 13 years with 64 % females. The mean pulmonary artery pressure (mPAP) was 46 ± 20 mmHg, mean left ventricular ejection fraction (LVEF) was 55 ± 13 %, and mean pulmonary capillary wedge pressure (PCWP) was 19 ± 9 mmHg. Of the 311 patients with PH, 121 (39 %) patients had ATa. Patients with ATa were older (p < 0.001) and were more likely to have systemic hypertension (p = 0.03), diabetes (p = 0.015), coronary artery disease (p < 0.001), heart failure (p < 0.001), mitral regurgitation (p = 0.001), impaired LVEF (p = 0.02), and left atrial enlargement (p < 0.001). There was no difference in the prevalence of ATa in mild, moderate, or severe PH. The mean PCWP was higher in patients with ATa (17.9 ± 9 vs 20.3 ± 8; p = 0.022). In multivariate analysis using Cox-proportional hazard model, the independent predictors of mortality were age (HR 1.05; p = 0.003), coronary artery disease (HR 2.34; p = 0.047), LVEF (HR 0.793; p = 0.023), and mPAP (HR 1.023; p = 0.003).

Conclusion

ATa are common in patients with PH. Left heart disease, left atrial enlargement, and elevated PCWP but not right atrial enlargement or mPAP predict the occurrence of ATa in patients with PH.

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Abbreviations

PH:

Pulmonary hypertension

AF:

Atrial fibrillation

SVT:

Supraventricular tachycardia

ATa:

Atrial tachyarrhythmia

LVEF:

Left ventricular ejection fraction

PCWP:

Pulmonary capillary wedge pressure

RHC:

Right heart catheterization

mPAP:

Mean pulmonary artery pressure

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Conflict of interest

None relevant to the current study.

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Authors and Affiliations

  1. Division of Cardiovascular Diseases and Bloch Heart Rhythm Center, Cardiovascular Research Institute, University of Kansas Hospital and Medical Center, 3901 Rainbow Boulevard MS 4023, Kansas City, KS, 66160-7200, USA

    Arun Kanmanthareddy, Yeruva Madhu Reddy, Jayasree Pillarisetti, Sudharani Bommana, Donita Atkins & Dhanunjaya Lakkireddy

  2. Division of Cardiology, Howard University, Washington, DC, USA

    Hemant Boolani

  3. Division of Pulmonary Critical Care, University of Kansas Hospital and Medical Center, Kansas City, KS, USA

    Sowjanya Duthuluru & Timothy Williamson

  4. Division of Cardiology, Metrohealth Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Ajay Vallakati

Authors
  1. Arun Kanmanthareddy
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  2. Yeruva Madhu Reddy
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  3. Hemant Boolani
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  4. Sowjanya Duthuluru
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  5. Jayasree Pillarisetti
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  7. Sudharani Bommana
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  8. Donita Atkins
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  9. Timothy Williamson
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  10. Dhanunjaya Lakkireddy
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Corresponding author

Correspondence to Dhanunjaya Lakkireddy.

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Kanmanthareddy, A., Reddy, Y.M., Boolani, H. et al. Incidence, predictors, and clinical course of atrial tachyarrhythmias in patients with pulmonary hypertension. J Interv Card Electrophysiol 41, 9–14 (2014). https://doi.org/10.1007/s10840-014-9928-5

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  • DOI: https://doi.org/10.1007/s10840-014-9928-5

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