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Objective:To explore the risk factors for atrial fibrillation(AF)in elderly Chinese patients with severe valvular heart disease(VHD).Methods:This was a cross-sectional study and consecutively enrolled 978 elderly patients with severe VHD diagnosed in 18 Class A tertiary hospitals across the country from September 2021 to March 2022, including 322(32.9%)patients with concurrent AF.Clinical and echocardiographic data were collected to analyze the risk factors for AF.Results:Among VHD patients, compared with the non-AF group, the AF group was older, had a higher female ratio, higher diastolic blood pressure, higher proportions with cerebrovascular disease and chronic kidney disease, lower serum low density lipoprotein cholesterol and higher serum creatinine, amino-terminal A-type natriuretion peptide and glycosylated hemoglobin.As for echocardiographic parameters, the left atrial diameter was larger, the left ventricular end-diastolic diameter, interventricular septum thickness, and left ventricular posterior wall thickness were smaller in the AF group than in the non-AF group.All of the differences were statistically significant(all P<0.05). The results of multivariate Logistic regression analysis showed that the left atrial anteroposterior diameter increased( OR=1.166, P<0.01), the left ventricular end-diastolic diameter decreased( OR=0.929, P<0.01), and advanced age( OR=1.051, P<0.05)was an independent risk factor for elderly VHD patients with concurrent AF. Conclusions:In elderly patients with severe VHD, advanced age, an increased left atrial anteroposterior diameter, and a decreased left ventricular end-diastolic diameter were independently associated with AF.Therefore, evaluation of cardiac structure and regular follow-up should be performed in elderly patients with severe VHD for early intervention to reduce the incidence of AF.
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Objective:To assess whether cardiac structure and function are associated with frailty in elderly inpatients.Methods:This was a cross-sectional study.Inpatients aged 65 years or over, admitted to Beijing Hospital, Chinese PLA General Hospital and Beijing Tsinghua Changgeng Hospital, were consecutively recruited from September 2018 to April 2019.A total of 925 elderly inpatients were enrolled in the study, including 285 frailty patients and 640 non-frailty patients.Frailty was assessed with the Fried frailty phenotype.Clinical and echocardiographic data were collected.The association of cardiac structure and function with frailty was analyzed.Results:Compared with the non-frailty group, the frailty group was older, had lower body mass index, and had higher rates of heart failure, atrial fibrillation/atrial flutter, history of stroke/transient ischemic attack, renal insufficiency, and history of falls.N-terminal B-type natriuretic peptide(NT-proBNP)levels were higher while creatinine clearance and hemoglobin levels were lower(all P<0.05); The frailty group had a larger anterior-posterior left atrial diameter[(37.8±7.1)mm vs.(36.3±5.1)mm, t=-3.134, P=0.002]and a higher proportion with the left atrial anterior posterior diameter ≥45 mm[15.8%(45/285) vs.6.1%(39/640), χ2=22.452, P<0.001], a lower left ventricular ejection fraction[(60.1±9.5)% vs.(61.9±7.5)%, t=2.817, P=0.005]and a faster peak mitral inflow velocity[(0.8±0.3)cm/s vs.(0.7±0.2)cm/s, t=-2.675, P=0.003]. Multivariate logistic regression analysis showed that the left atrial anterior posterior diameter ≥45 mm was an independent correlation factor for frailty( OR=2.249, P=0.015). Increased age( OR=1.099, P<0.001), heart failure( OR=1.786, P=0.049), history of stroke/transient ischemic attack( OR=1.960, P=0.001)and decreased hemoglobin( OR=0.984, P=0.008)were independently associated with frailty. Conclusions:The left atrial anterior posterior diameter ≥45 mm and heart failure were independently associated with frailty.Assessing cardiac structure and function and screening for cardiovascular diseases in frailty patients should be emphasized.