Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry

Öz:

Objective: The aim of this study was to assess the clinical characteristics of patients with heart failure and preserved ejection fraction (HFpEF) and atrial fibrillation (AF) and compare them with those of HFpEF patients without AF. Methods: This study was a sub-group analysis of a multicenter, observational, and cross-sectional registry conducted in Turkey (ClinicalTrials.gov identifier: NCT03026114). Patients with HFpEF were divided into 2 groups: HFpEF with AF and HFpEF with sinus rhythm (SR), and the clinical characteristics of the groups were compared. Results: In a total of 819 HFpEF patients (median age: 67 years; 58% women), 313 (38.2%) had AF. Compared to the patients with SR, those with AF were older (70 years vs 66 years; p<0.001) and more symptomatic, with a higher rate of classification as New York Heart Association functional class III-IV, paroxysmal nocturnal dyspnea, orthopnea, palpitations, fatigue, pulmonary crepitations, and peripheral edema. The hospitalization rate for heart failure was higher (28.4% vs 12.6%; p<0.001) in patients with AF, and participants with AF had higher level of N-terminal pro-B-type natriuretic peptide (887 pg/mL vs 394.8 pg/mL; p<0.001) and higher left atrial volume index level. Patients without AF had a higher burden of diabetes mellitus, obstructive sleep apnea, and coronary artery disease. The prescription rate of nondihydropyridine calcium blockers, digoxin, loop diuretics, and anticoagulant drugs was higher in the AF group. Conclusion: The results of this study revealed that in a large Turkish cohort with HFpEF, significant clinical differences were present between those with and without AF and. Further prospective studies are needed to clarify the prognostic implications of AF in this growing heart failure population in our country.

Anahtar Kelime:

Atriyal fibrilasyon ve sinüs ritminde olan korunmuş ejeksiyon fraksiyonlu kalp yetersizliği hastalarının klinik özelliklerinin karşılaştırılması: APOLLON çalışmasından sonuçlar

Öz:

Amaç: Atriyal fibrilasyonu (AF) bulunan korunmuş ejeksiyon fraksiyonlu kalp yetersizliği (KEF-KY) hastalarının klinik özelliklerini değerlendirmeyi ve bu hastaların klinik özelliklerini AF’si bulunmayan KEF-KY hastalarıyla karşılaştırmayı amaçladık. Yöntemler: Bu çalışma, Türkiye’de yürütülmüş olan, daha kapsamlı, çok merkezli, gözlemsel ve kesitsel bir kayıt çalışmasının alt grup analizi olarak tasarlandı (NCT03026114). KEF-KY hastaları; AF ritminde olan KEF-KY hastaları ve sinüs ritminde (SR) olan KEF-KY hastaları olarak iki gruba ayrılarak, bu hastaların klinik karakteristik özellikleri karşılaştırıldı. Bulgular: Toplam 819 KEF-KY hastası (ortanca yaş 67 yıl, %58 kadın) içinde, 313 (%38.2) hastada AF mevcuttu. SR olan hastalara kıyasla, AF mevcut olan hastalar daha yaşlı (70’e karşı 66 yıl, p<0.001) ve daha semptomatikti. NYHA IIIIV fonksiyonel kapasite, paroksismal nokturnal dispne, ortopne, çarpıntı, yorgunluk, akciğerlerde krepitan ral ve periferik ödem prevalansı AF ritmindeki hastalarda daha yüksekti. Kalp yetersizliğine bağlı hastaneye yatış oranı AF hastalarında daha fazlaydı (%28.4’e karşı %12.6, p<0.001) ve AF hastaları belirgin olarak daha yüksek N-terminal pro-B-tipi natriüretik peptit (887’ye karşı 394.8 pg/mL, p<0.001) ve sol atriyum volüm indeksi değerlerine sahipti. Bununla birlikte, AF mevcut olmayan hastalar daha yüksek diabetes mellitus, obstrüktif uyku apnesi ve koroner arter hastalığı yüküne sahipti. Ayrıca AF grubunda, nondihidropiridin grubu kalsiyum kanal blokerleri, digoksin, loop diüretikleri ve antikoagülan ilaç kullanım oranları daha fazlaydı. Sonuç: Bu çalışma Türkiye’deki geniş bir KEF-KY kohortunda AF ritminde olan ve olmayan hastalar arasında önemli klinik farklılıklar olduğunu göstermiştir. Ülkemizde de giderek artan bu kalp yetersizliği popülasyonunda, AF’nin prognostik etkilerini netleştirmek için daha ileri, prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÖZLEK B, ÖZLEK E, TEKİNALP M, Kahraman S, ZENCİRKİRAN H, basaran o, kaya b, RENCÜZOĞULLARI İ, MERT K, ÇAKIR O, ösken a, BEKAR L, ÇELİK M, ÇİL C, doğan v, ÇELİK O, MERT G, MEMİÇ SANCAR K, SEVİNÇ S, BİTEKER M (2020). Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. , 234 - 245. doi: 10.5543/tkda.2019.77236
Chicago	ÖZLEK BÜLENT,ÖZLEK EDA,TEKİNALP MEHMET,Kahraman Serkan,ZENCİRKİRAN Hicaz,basaran ozcan,kaya bedri caner,RENCÜZOĞULLARI İbrahim,MERT Kadir Ugur,ÇAKIR Ozan,ösken altuğ,BEKAR Lütfü,ÇELİK M. Yunus,ÇİL CEM,doğan volkan,ÇELİK OĞUZHAN,MERT GURBET ÖZGE,MEMİÇ SANCAR Kadriye,SEVİNÇ SAMET,BİTEKER MURAT Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. (2020): 234 - 245. doi: 10.5543/tkda.2019.77236
MLA	ÖZLEK BÜLENT,ÖZLEK EDA,TEKİNALP MEHMET,Kahraman Serkan,ZENCİRKİRAN Hicaz,basaran ozcan,kaya bedri caner,RENCÜZOĞULLARI İbrahim,MERT Kadir Ugur,ÇAKIR Ozan,ösken altuğ,BEKAR Lütfü,ÇELİK M. Yunus,ÇİL CEM,doğan volkan,ÇELİK OĞUZHAN,MERT GURBET ÖZGE,MEMİÇ SANCAR Kadriye,SEVİNÇ SAMET,BİTEKER MURAT Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. , 2020, ss.234 - 245. doi: 10.5543/tkda.2019.77236
AMA	ÖZLEK B,ÖZLEK E,TEKİNALP M,Kahraman S,ZENCİRKİRAN H,basaran o,kaya b,RENCÜZOĞULLARI İ,MERT K,ÇAKIR O,ösken a,BEKAR L,ÇELİK M,ÇİL C,doğan v,ÇELİK O,MERT G,MEMİÇ SANCAR K,SEVİNÇ S,BİTEKER M Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. . 2020; 234 - 245. doi: 10.5543/tkda.2019.77236
Vancouver	ÖZLEK B,ÖZLEK E,TEKİNALP M,Kahraman S,ZENCİRKİRAN H,basaran o,kaya b,RENCÜZOĞULLARI İ,MERT K,ÇAKIR O,ösken a,BEKAR L,ÇELİK M,ÇİL C,doğan v,ÇELİK O,MERT G,MEMİÇ SANCAR K,SEVİNÇ S,BİTEKER M Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. . 2020; 234 - 245. doi: 10.5543/tkda.2019.77236
IEEE	ÖZLEK B,ÖZLEK E,TEKİNALP M,Kahraman S,ZENCİRKİRAN H,basaran o,kaya b,RENCÜZOĞULLARI İ,MERT K,ÇAKIR O,ösken a,BEKAR L,ÇELİK M,ÇİL C,doğan v,ÇELİK O,MERT G,MEMİÇ SANCAR K,SEVİNÇ S,BİTEKER M "Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry." , ss.234 - 245, 2020. doi: 10.5543/tkda.2019.77236
ISNAD	ÖZLEK, BÜLENT vd. "Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry". (2020), 234-245. https://doi.org/doi: 10.5543/tkda.2019.77236

APA	ÖZLEK B, ÖZLEK E, TEKİNALP M, Kahraman S, ZENCİRKİRAN H, basaran o, kaya b, RENCÜZOĞULLARI İ, MERT K, ÇAKIR O, ösken a, BEKAR L, ÇELİK M, ÇİL C, doğan v, ÇELİK O, MERT G, MEMİÇ SANCAR K, SEVİNÇ S, BİTEKER M (2020). Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. Türk Kardiyoloji Derneği Arşivi, 48(3), 234 - 245. doi: 10.5543/tkda.2019.77236
Chicago	ÖZLEK BÜLENT,ÖZLEK EDA,TEKİNALP MEHMET,Kahraman Serkan,ZENCİRKİRAN Hicaz,basaran ozcan,kaya bedri caner,RENCÜZOĞULLARI İbrahim,MERT Kadir Ugur,ÇAKIR Ozan,ösken altuğ,BEKAR Lütfü,ÇELİK M. Yunus,ÇİL CEM,doğan volkan,ÇELİK OĞUZHAN,MERT GURBET ÖZGE,MEMİÇ SANCAR Kadriye,SEVİNÇ SAMET,BİTEKER MURAT Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. Türk Kardiyoloji Derneği Arşivi 48, no.3 (2020): 234 - 245. doi: 10.5543/tkda.2019.77236
MLA	ÖZLEK BÜLENT,ÖZLEK EDA,TEKİNALP MEHMET,Kahraman Serkan,ZENCİRKİRAN Hicaz,basaran ozcan,kaya bedri caner,RENCÜZOĞULLARI İbrahim,MERT Kadir Ugur,ÇAKIR Ozan,ösken altuğ,BEKAR Lütfü,ÇELİK M. Yunus,ÇİL CEM,doğan volkan,ÇELİK OĞUZHAN,MERT GURBET ÖZGE,MEMİÇ SANCAR Kadriye,SEVİNÇ SAMET,BİTEKER MURAT Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. Türk Kardiyoloji Derneği Arşivi, vol.48, no.3, 2020, ss.234 - 245. doi: 10.5543/tkda.2019.77236
AMA	ÖZLEK B,ÖZLEK E,TEKİNALP M,Kahraman S,ZENCİRKİRAN H,basaran o,kaya b,RENCÜZOĞULLARI İ,MERT K,ÇAKIR O,ösken a,BEKAR L,ÇELİK M,ÇİL C,doğan v,ÇELİK O,MERT G,MEMİÇ SANCAR K,SEVİNÇ S,BİTEKER M Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. Türk Kardiyoloji Derneği Arşivi. 2020; 48(3): 234 - 245. doi: 10.5543/tkda.2019.77236
Vancouver	ÖZLEK B,ÖZLEK E,TEKİNALP M,Kahraman S,ZENCİRKİRAN H,basaran o,kaya b,RENCÜZOĞULLARI İ,MERT K,ÇAKIR O,ösken a,BEKAR L,ÇELİK M,ÇİL C,doğan v,ÇELİK O,MERT G,MEMİÇ SANCAR K,SEVİNÇ S,BİTEKER M Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry. Türk Kardiyoloji Derneği Arşivi. 2020; 48(3): 234 - 245. doi: 10.5543/tkda.2019.77236
IEEE	ÖZLEK B,ÖZLEK E,TEKİNALP M,Kahraman S,ZENCİRKİRAN H,basaran o,kaya b,RENCÜZOĞULLARI İ,MERT K,ÇAKIR O,ösken a,BEKAR L,ÇELİK M,ÇİL C,doğan v,ÇELİK O,MERT G,MEMİÇ SANCAR K,SEVİNÇ S,BİTEKER M "Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry." Türk Kardiyoloji Derneği Arşivi, 48, ss.234 - 245, 2020. doi: 10.5543/tkda.2019.77236
ISNAD	ÖZLEK, BÜLENT vd. "Comparison of clinical characteristics of patients with heart failure and preserved ejection fraction with atrial fibrillation versus sinus rhythm: Insights from the APOLLON registry". Türk Kardiyoloji Derneği Arşivi 48/3 (2020), 234-245. https://doi.org/doi: 10.5543/tkda.2019.77236