ISSN: 2706-8870
Volume 6, Number 5 (2021)
Year Launched: 2016

Testing microalbuminuria improved detective ability of atrial fibrillation in hypertrophic cardiomyopathy patients

Volume 6, Issue 5, October 2021     |     PP. 365-380      |     PDF (339 K)    |     Pub. Date: September 5, 2021
DOI: 10.54647/cm32584    81 Downloads     4863 Views  

Author(s)

Xiaowei Jiang, Cardiology department, Xiangya hospital Central South University, Changsha, Hunan, China.
Min Yan, Internal medicine department, Changsha Medical University, Changsha, Hunan, China.

Abstract
Atrial fibrillation (AF) is common arrhythmia in hypertrophic cardiomyopathy (HCM) patients, and indicate badly prognosis. The aim of this study was to determine the value of testing microalbuminuria (MAU) to improve the detective ability of atrial fibrillation in hypertrophic cardiomyopathy patients. The study was retrospective study. 267 patients with HCM were included from June 2013 to June 2016. Urinary albumin excretion (UAE) was detected by immunoturbidimetry method. AF was defined according to Minnesota codes. Huge atrial dimension was defined as left atrial end-systolic dimension (LAESD)≥ 50mm. 267 patients were enrolled consecutively, 37(13.9%) had AF and 47(17.6%) had MAU. The levels of UAE increased with the prevalence of AF and huge atrial dimension. In multivariate logistic analysis, age, LAESD and UAE were significantly associated with AF. Compared with patients without MAU, patients with MAU were associated with increased risk of AF and huge atrial dimension. Combined measurements of age≥ 51.5 years, LAESD≥ 44.5mm and UAE≥ 22.6 mg/L indicated good predictive values in the presence of AF, with a specificity of 87.8% and a sensitivity of 86.5% in HCM patients. MAU might be a valuable index to evaluate the clinical status of AF in HCM patients. Testing MAU improve the detective ability of atrial fibrillation in hypertrophic cardiomyopathy patients.

Keywords
Albuminuria; Hypertrophic cardiomyopathy; Atrial fibrillation

Cite this paper
Xiaowei Jiang, Min Yan, Testing microalbuminuria improved detective ability of atrial fibrillation in hypertrophic cardiomyopathy patients , SCIREA Journal of Clinical Medicine. Volume 6, Issue 5, October 2021 | PP. 365-380. 10.54647/cm32584

References

[ 1 ] Ho CY, Lopez B, Coelho-Filho OR, Lakdawala NK, Cirino AL, Jarolim P. Myocardial fibrosis as an early manifestation of hypertrophic cardiomyopathy. N Engl J Med 2010; 363: 552-563.
[ 2 ] Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998; 82: 2N-9N.
[ 3 ] Wattigney WA, Mensah GA, Croft JB. Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999: implications for primary prevention. Circulation 2003; 108: 711-716.
[ 4 ] Alatas OD, Biteker M. Prognostic value of microalbuminuria on admission in patients with acute pulmonary embolism. Heart Lung 2020; 49: 749-752.
[ 5 ] Stehouwer CD, Gall MA, Twisk JW, Knudsen E, Emeis JJ, Parving HH. Increased urinary albumin excretion, endothelial dysfunction, and chronic low-grade inflammation in type 2 diabetes: progressive, interrelated, and independently associated with risk of death. Diabetes 2002; 51: 1157-1165.
[ 6 ] Salles GF, Fiszman R, Cardoso CR, Muxfeldt ES. Relation of left ventricular hypertrophy with systemic inflammation and endothelial damage in resistant hypertension. Hypertension 2007; 50: 723-728.
[ 7 ] Bohm M, Thoenes M, Neuberger HR, Graber S, Reil JC, Bramlage P. Atrial fibrillation and heart rate independently correlate to microalbuminuria in hypertensive patients. Eur Heart J 2009; 30: 1364-1371.
[ 8 ] Cohen RV, Pereira TV, Aboud CM, Petry T, Lopes CJ, Schiavon CA. Effect of Gastric Bypass vs Best Medical Treatment on Early-Stage Chronic Kidney Disease in Patients With Type 2 Diabetes and Obesity: A Randomized Clinical Trial. Jama Surg 2020; 155: e200420.
[ 9 ] Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 2014; 35: 2733-2779.
[ 10 ] Nagueh SF, Bierig SM, Budoff MJ, Desai M, Dilsizian V, Eidem B. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with hypertrophic cardiomyopathy: Endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Magnetic Resonance, and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr 2011; 24: 473-498.
[ 11 ] Zhang C, Liu R, Yuan J, Cui J, Hu F, Yang W. Significance and Determinants of Cardiac Troponin I in Patients With Obstructive Hypertrophic Cardiomyopathy. Am J Cardiol 2015; 116: 1744-1751.
[ 12 ] Schmieder RE, Schrader J, Zidek W, Tebbe U, Paar WD, Bramlage P. Low-grade albuminuria and cardiovascular risk : what is the evidence? Clin Res Cardiol 2007; 96: 247-257.
[ 13 ] Goette A, Bukowska A, Lendeckel U, Erxleben M, Hammwohner M, Strugala D. Angiotensin II receptor blockade reduces tachycardia-induced atrial adhesion molecule expression. Circulation 2008; 117: 732-742.
[ 14 ] Asselbergs FW, van den Berg MP, Diercks GF, van Gilst WH, van Veldhuisen DJ. C-reactive protein and microalbuminuria are associated with atrial fibrillation. Int J Cardiol 2005; 98: 73-77.
[ 15 ] Akar JG, Jeske W, Wilber DJ. Acute onset human atrial fibrillation is associated with local cardiac platelet activation and endothelial dysfunction. J Am Coll Cardiol 2008; 51: 1790-1793.
[ 16 ] Sinno H, Derakhchan K, Libersan D, Merhi Y, Leung TK, Nattel S. Atrial ischemia promotes atrial fibrillation in dogs. Circulation 2003; 107: 1930-1936.
[ 17 ] Clark DM, Plumb VJ, Epstein AE, Kay GN. Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation. J Am Coll Cardiol 1997; 30: 1039-1045.
[ 18 ] Moubarak M, Jabbour H, Smayra V, Chouery E, Saliba Y, Jebara V. Cardiorenal syndrome in hypertensive rats: microalbuminuria, inflammation and ventricular hypertrophy. Physiol Res 2012; 61: 13-24.
[ 19 ] Saliba Y, Chouery E, Megarbane A, Jabbour H, Fares N. Microalbuminuria versus brain natriuretic peptide in cardiac hypertrophy of hypertensive rats. Physiol Res 2010; 59: 871-880.
[ 20 ] McMurray J, Seidelin PH, Howey JE, Balfour DJ, Struthers AD. The effect of atrial natriuretic factor on urinary albumin and beta 2-microglobulin excretion in man. J Hypertens 1988; 6: 783-786.