Clinical ResearchArterial Stiffness Is Associated With Increased Symptom Burden in Patients With Atrial Fibrillation
Section snippets
Trial registration
This trial is registered in the German registry for clinical studies (DRKS00019007).
Study design
The study design complies with the declaration of Helsinki and was approved by the local ethical committee, Medical Ethic Commission II, Faculty of Medicine Mannheim, University of Heidelberg, Germany. Data protection was in accordance to the European Union Data Protection Directive.
Data statement
Data will be made available upon reasonable request.
Setting
One hundred sixty-two consecutive patients with paroxysmal or persistent AF
Results
The study group consisted of 162 patients. Thirty patients (18.5%) reported absolutely no symptoms and were therefore considered asymptomatic. Forty-eight patients (29.6%) had mild symptoms, that they associated with AF. Although 8 patients (4.9%) reported moderate symptoms, most of the study population (70 patients; 43.2%) complained of severe symptoms. Only 6 patients (3.7%) reported disabling symptoms (Table 1).
The study population represents a classic cardiological collective, with a median
Discussion
The results of the present study show an association between increased AS and a higher symptom burden in patients with AF. Because no continuous rhythm recording was performed to provide a symptom:rhythm correlation, we cannot say for certain whether the described symptoms were actually due to AF. AS might be the consequence of a high burden of risk factors and comorbidities, which might contribute to a high symptom burden even in patients without AF.
The question why some patients suffering
Conclusion
AS contributes to a high symptom burden in patients with AF. Because increased AS might also be the consequence of a high burden of cardiovascular risk factors and comorbidities, increased AS itself might contribute to symptoms, even between AF episodes, when patients are in sinus rhythm, which might explain why patients with paroxysmal AF often report continuous symptoms. Moreover, increased AS might be a surrogate for subclinical left ventricular diastolic dysfunction and could therefore be
Acknowledgements
Special thanks to Prof Borggrefe for the initial idea and impulse for the conception of the study.
Funding Sources
The authors have no funding sources to declare.
Disclosures
The authors have no conflicts of interest to disclose.
References (28)
- et al.
Asymptomatic atrial fibrillation: demographic features and prognostic information from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study
Am Heart J
(2005) - et al.
A novel, simple scale for assessing the symptom severity of atrial fibrillation at the bedside: the CCS-SAF scale
Can J Cardiol
(2006) - et al.
Circumferential and longitudinal cyclic strain of the human thoracic aorta: age-related changes
J Vasc Surg
(2009) - et al.
Influence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: the Fibrillation Registry Assessing Costs, Therapies, Adverse events and Lifestyle (FRACTAL) study
Am Heart J
(2006) - et al.
Asymptomatic persistent atrial fibrillation and outcome: results of the RACE study
Heart Rhythm
(2014) - et al.
Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study
Eur Heart J
(2006) - et al.
Arterial stiffness and left ventricular performance in elderly patients with persistent atrial fibrillation
Aging Clin Exp Res
(2018) - et al.
Impact of atrial fibrillation on the risk of death: the Framingham Heart Study
Circulation
(1998) - et al.
Quality of life in patients with atrial fibrillation: a systematic review
Am J Med
(2006) - et al.
Characterization of different subsets of atrial fibrillation in general practice in France: the ALFA study
Circulation
(1999)
Arterial stiffness predicts incident atrial fibrillation in the Framingham Heart Study: a mechanistic contribution in people with high blood pressure or history of hypertension
Hypertension
Carotid intima-media thickness and arterial stiffness and the risk of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study, Multi-Ethnic Study of Atherosclerosis (MESA), and the Rotterdam Study
J Am Heart Assoc
Atrial fibrillation after electrical cardioversion in elderly patients: a role for arterial stiffness? Results from a preliminary study
Aging Clin Exp Res
Aortic stiffness in lone atrial fibrillation: a novel risk factor for arrhythmia recurrence
PLoS One
Cited by (6)
Clinical utility of rhythm control by electrical cardioversion to assess the association between self-reported symptoms and rhythm status in patients with persistent atrial fibrillation
2021, IJC Heart and VasculatureCitation Excerpt :Sociodemographic- and sex-specific factors as well as anxiety- and depression-related mechanisms may be involved in the type or severity of self-reported symptoms in AF patients [21]. Additionally, symptoms in AF patients related to certain comorbidities such as heart failure, obesity, diabetes, coronary artery disease, arterial stiffness, and sleep-disordered breathing may perpetuate and contribute significantly to the perception and judgement of the frequency and severity of AF-related symptoms as well [22–25]. Therefore, additional studies evaluating the effect of specific concomitant non-cardiovascular and cardiovascular conditions and risk factors on overall symptom burden are needed.
Arterial Stiffness Association With Symptom Burden in Patients With Atrial Fibrillation: Direct Cause or Marker of Concomitant Risk Factors?
2020, Canadian Journal of CardiologyArterial stiffness and atrial fibrillation: Shared mechanisms, clinical implications and therapeutic options
2022, Journal of HypertensionNetwork Pharmacology and Pharmacological Mechanism of CV-3 in Atrial Fibrillation
2022, Evidence-based Complementary and Alternative Medicine
See editorial by Hermans et al., pages 1843–1846of this issue.
See page 1954 for disclosure information.