Current concepts on predictors of atrial fibrillation occurrence and progression

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.6.232397

Keywords:

atrial fibrillation, complications, mortality, predictors

Abstract

The aim was to summarize and present a current views on the clinical, electrophysiological, hemodynamic and neurohumoral predictors of atrial fibrillation occurrence and progression by reviewing contemporary specialized literature. Atrial fibrillation has been shown to be the most common cardiac arrhythmia in clinical practice, associated with an increased risk of thromboembolic complications and cardiovascular mortality. However, there is no optimal prognostic marker for this type of arrhythmia onset and progression.

Conclusions. It has been established that the main predictors of atrial fibrillation and its complications are electrophysiological, structural and functional changes of the heart with underlying neurohumoral and pro-inflammatory activation, hypercoagulation and genetic predisposition.

Author Biography

S. M. Kyselov, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Internal Diseases 1 and Simulation Medicine

References

Atlas Writing Group, ESC Atlas of Cardiology is a compendium of cardiovascular statistics compiled by the European Heart Agency, a department of the European Society of Cardiology, Developed in collaboration with the national societies of the European Society of Cardiology member countries, Timmis, A., Townsend, N., Gale, C. P., Torbica, A., Lettino, M., Petersen, S. E., Mossialos, E. A., Maggioni, A. P., Kazakiewicz, D., May, H. T., De Smedt, D., Flather, M., Zuhlke, L., Beltrame, J. F., Huculeci, R., Tavazzi, L., Hindricks, G., … Vardas, P. (2020). European Society of Cardiology: Cardiovascular Disease Statistics 2019 (Executive Summary). European Heart Journal - Quality of Care & Clinical Outcomes, 6(1), 7-9. https://doi.org/10.1093/ehjqcco/qcz065

Ugowe, F. E., & Jackson, L. R., 2nd. (2019). Atrial fibrillation and mortality risk: seeing the big picture. European Heart Journal - Quality of Care & Clinical Outcomes, 5(1), 6-7. https://doi.org/10.1093/ehjqcco/qcy050

Tomasdottir, M., Friberg, L., Hijazi, Z., Lindbäck, J., & Oldgren, J. (2019). Risk of ischemic stroke and utility of CHA2DS2-VASc score in women and men with atrial fibrillation. Clinical Cardiology, 42(10), 1003-1009. https://doi.org/10.1002/clc.23257

Meyre, P., Blum, S., Berger, S., Aeschbacher, S., Schoepfer, H., Briel, M., Osswald, S., & Conen, D. (2019). Risk of Hospital Admissions in Patients With Atrial Fibrillation: A Systematic Review and Meta-analysis. Canadian Journal of Cardiology, 35(10), 1332-1343. https://doi.org/10.1016/j.cjca.2019.05.024

Sepehri Shamloo, A., Dagres, N., Müssigbrodt, A., Stauber, A., Kircher, S., Richter, S., Dinov, B., Bertagnolli, L., Husser-Bollmann, D., Bollmann, A., Hindricks, G. & Arya, A. (2020). Atrial Fibrillation and Cognitive Impairment: New Insights and Future Directions. Heart, Lung and Circulation, 29(1), 69-85. https://doi.org/10.1016/j.hlc.2019.05.185

Ziff, O. J., Carter, P. R., McGowan, J., Uppal, H., Chandran, S., Russell, S., Bainey, K. R., & Potluri, R. (2018). The interplay between atrial fibrillation and heart failure on long-term mortality and length of stay: Insights from the, United Kingdom ACALM registry. International Journal of Cardiology, 252, 117-121. https://doi.org/10.1016/j.ijcard.2017.06.033

Pastori, D., Pignatelli, P., Menichelli, D., Violi, F., & Lip, G. (2019). Integrated Care Management of Patients With Atrial Fibrillation and Risk of Cardiovascular Events: The ABC (Atrial fibrillation Better Care) Pathway in the ATHERO-AF Study Cohort. Mayo Clinic Proceedings, 94(7), 1261-1267. https://doi.org/10.1016/j.mayocp.2018.10.022

Alkhouli, M., & Friedman, P. A. (2019). Ischemic Stroke Risk in Patients With Nonvalvular Atrial Fibrillation: JACC Review Topic of the Week. Journal of the American College of Cardiology, 74(24), 3050-3065. https://doi.org/10.1016/j.jacc.2019.10.040

Wu, V. C., Wu, M., Aboyans, V., Chang, S. H., Chen, S. W., Chen, M. C., Wang, C. L., Hsieh, I. C., Chu, P. H., & Lin, Y. S. (2020). Female sex as a risk factor for ischaemic stroke varies with age in patients with atrial fibrillation. Heart, 106(7), 534-540. https://doi.org/10.1136/heartjnl-2019-315065

Kim, T. H., Yang, P. S., Yu, H. T., Jang, E., Uhm, J. S., Kim, J. Y., Pak, H. N., Lee, M. H., Joung, B., & Lip, G. (2018). Age Threshold for Ischemic Stroke Risk in Atrial Fibrillation. Stroke, 49(8), 1872-1879. https://doi.org/10.1161/STROKEAHA.118.021047

Chao, T. F., Lip, G., Liu, C. J., Lin, Y. J., Chang, S. L., Lo, L. W., Hu, Y. F., Tuan, T. C., Liao, J. N., Chung, F. P., Chen, T. J., & Chen, S. A. (2018). Relationship of Aging and Incident Comorbidities to Stroke Risk in Patients With Atrial Fibrillation. Journal of the American College of Cardiology, 71(2), 122-132. https://doi.org/10.1016/j.jacc.2017.10.085

Fangel, M. V., Nielsen, P. B., Larsen, T. B., Christensen, B., Overvad, T. F., Lip, G., Goldhaber, S. Z., & Jensen, M. B. (2018). Type 1 versus type 2 diabetes and thromboembolic risk in patients with atrial fibrillation: A Danish nationwide cohort study. International Journal of Cardiology, 268, 137-142. https://doi.org/10.1016/j.ijcard.2018.05.037

Decker, J. J., Norby, F. L., Rooney, M. R., Soliman, E. Z., Lutsey, P. L., Pankow, J. S., Alonso, A., & Chen, L. Y. (2019). Metabolic Syndrome and Risk of Ischemic Stroke in Atrial Fibrillation: ARIC Study. Stroke, 50(11), 3045-3050. https://doi.org/10.1161/STROKEAHA.119.025376

Bassand, J. P., Accetta, G., Al Mahmeed, W., Corbalan, R., Eikelboom, J., Fitzmaurice, D. A., Fox, K., Gao, H., Goldhaber, S. Z., Goto, S., Haas, S., Kayani, G., Pieper, K., Turpie, A., van Eickels, M., Verheugt, F., Kakkar, A. K., & GARFIELD-AF Investigators. (2018). Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: Rationale for comprehensive management of atrial fibrillation. PLOS ONE, 13(1), Article e0191592. https://doi.org/10.1371/journal.pone.0191592

Ogawa, H., An, Y., Ikeda, S., Aono, Y., Doi, K., Ishii, M., Iguchi, M., Masunaga, N., Esato, M., Tsuji, H., Wada, H., Hasegawa, K., Abe, M., Lip, G., Akao, M., & Fushimi AF Registry Investigators. (2018). Progression From Paroxysmal to Sustained Atrial Fibrillation Is Associated With Increased Adverse Events. Stroke, 49(10), 2301-2308. https://doi.org/10.1161/STROKEAHA.118.021396

B Schnabel, R., Pecen, L., Engler, D., Lucerna, M., Sellal, J. M., Ojeda, F. M., De Caterina, R., & Kirchhof, P. (2018). Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes. Heart, 104(19), 1608-1614. https://doi.org/10.1136/heartjnl-2017-312569

Dilaveris, P. E., & Kennedy, H. L. (2017). Silent atrial fibrillation: epidemiology, diagnosis, and clinical impact. Clinical Cardiology, 40(6), 413-418. https://doi.org/10.1002/clc.22667

Guerra, F., Brambatti, M., Nieuwlaat, R., Marcucci, M., Dudink, E., Crijns, H., Matassini, M. V., & Capucci, A. (2017). Symptomatic atrial fibrillation and risk of cardiovascular events: data from the Euro Heart Survey. EP Europace, 19(12), 1922-1929. https://doi.org/10.1093/europace/eux205

Shin, S. Y., Han, S. J., Kim, J. S., Im, S. I., Shim, J., Ahn, J., Lee, E. M., Park, Y. M., Kim, J. H., Lip, G., & Lim, H. E. (2019). Identification of Markers Associated With Development of Stroke in «Clinically Low-Risk» Atrial Fibrillation Patients. Journal of the American Heart Association, 8(21), Article e012697. https://doi.org/10.1161/JAHA.119.012697

Rivera-Caravaca, J. M., Marín, F., Vilchez, J. A., Gálvez, J., Esteve-Pastor, M. A., Vicente, V., Lip, G., & Roldán, V. (2019). Refining Stroke and Bleeding Prediction in Atrial Fibrillation by Adding Consecutive Biomarkers to Clinical Risk Scores. Stroke, 50(6), 1372-1379. https://doi.org/10.1161/STROKEAHA.118.024305

Oldgren, J., Hijazi, Z., Lindbäck, J., Alexander, J. H., Connolly, S. J., Eikelboom, J. W., Ezekowitz, M. D., Granger, C. B., Hylek, E. M., Lopes, R. D., Siegbahn, A., Yusuf, S., Wallentin, L., & RE-LY and ARISTOTLE Investigators. (2016). Performance and Validation of a Novel Biomarker-Based Stroke Risk Score for Atrial Fibrillation. Circulation, 134(22), 1697-1707. https://doi.org/10.1161/CIRCULATIONAHA.116.022802

Ioannou, A., Papageorgiou, N., Falconer, D., Rehal, O., Sewart, E., Zacharia, E., Toutouzas, K., Vlachopoulos, C., Siasos, G., Tsioufis, C., & Tousoulis, D. (2019). Biomarkers Associated with Stroke Risk in Atrial Fibrillation. Current Medicinal Chemistry, 26(5), 803-823. https://doi.org/10.2174/0929867324666170718120651

Esteve-Pastor, M. A., Roldán, V., Rivera-Caravaca, J. M., Ramírez-Macías, I., Lip, G., & Marín, F. (2019). The Use of Biomarkers in Clinical Management Guidelines: A Critical Appraisal. Thrombosis and Haemostasis, 119(12), 1901-1919. https://doi.org/10.1055/s-0039-1696955

Petryszyn, P., Niewinski, P., Staniak, A., Piotrowski, P., Well, A., Well, M., Jeskowiak, I., Lip, G., & Ponikowski, P. (2019). Effectiveness of screening for atrial fibrillation and its determinants. A meta-analysis. PLOS ONE, 14(3), Article e0213198. https://doi.org/10.1371/journal.pone.0213198

Mironov, N. Yu., Laiovich, L. Yu., Mironova, E. S., Sharf, T. V., Aparina, O. P., Mironova, N. A., Stukalova, O. V., Yuricheva, Yu. A., Sokolov, S. F., Novikov, I. A., Maykov, E. B., Pevzner, A. V., & Golitsyn, S. P. (2019). Novye dostizheniya v diagnostike i lechenii fibrillyatsii predserdii: ot eksperimental'nykh issledovanii do povsednevnoi klinicheskoi praktiki [Recent advances in diagnosis and management of atrial fibrillation]. Terapevticheskii arkhiv, 91(6), 11-18. https://doi.org/10.26442/00403660.2019.06.000295 [in Russian].

Mironova, E. S., Mironov, N. Yu., Mironova, N. A., Novikov, P. S., Novikov, I. A., Laiovich, L. Yu., Maikov, E. B., & Golitsyn, S. P. (2019). Elektrofiziologicheskie parametry serdtsa i rezul'taty protivoaritmicheskogo lecheniya u bol'nykh s paroksizmal'noi formoi fibrillyatsii predserdii, idiopaticheskoi i v sochetanii s gipertonicheskoi bolezn'yu [Electrophysiological Cardiac Parameters and Results of Antiarrhythmic Treatment in Patients with Paroxysmal Atrial Fibrillation (Lone and Associated with Arterial Hypertension)]. Kardiologiya, 59(8), 39-46. https://doi.org/10.18087/cardio.2019.8.n644 [in Russian].

Baranchuk, A., & Yeung, C. (2018). Advanced interatrial block predicts atrial fibrillation recurrence across different populations: Learning Bayés syndrome. International Journal of Cardiology, 272, 221-222. https://doi.org/10.1016/j.ijcard.2018.08.025

Attia, Z. I., Noseworthy, P. A., Lopez-Jimenez, F., Asirvatham, S. J., Deshmukh, A. J., Gersh, B. J., Carter, R. E., Yao, X., Rabinstein, A. A., Erickson, B. J., Kapa, S., & Friedman, P. A. (2019). An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction. Lancet, 394(10201), 861-867. https://doi.org/10.1016/S0140-6736(19)31721-0

Steinhubl, S. R., Waalen, J., Edwards, A. M., Ariniello, L. M., Mehta, R. R., Ebner, G. S., Carter, C., Baca-Motes, K., Felicione, E., Sarich, T., & Topol, E. J. (2018). Effect of a Home-Based Wearable Continuous ECG Monitoring Patch on Detection of Undiagnosed Atrial Fibrillation: The mSToPS Randomized Clinical Trial. JAMA, 320(2), 146-155. https://doi.org/10.1001/jama.2018.8102

Khidirova, L. D., Yakhontov, D. A., & Lukinov, V. L. (2020). Personifitsirovannyi algoritm formirovaniya grupp riska progressirovaniya i razvitiya oslozhnenii fibrillyatsii predserdii pri gipertonicheskoi bolezni v sochetanii s ekstrakardial'nymi zabolevaniyami [Personalized algorithm for formation of risk groups for progression and development of complications of atrial fibrillation in hypertension in combination with extracardial diseases]. Meditsinskii alfavit, (13), 16-19. https://doi.org/10.33667/2078-5631-2020-13-16-19 [in Russian].

Solovyan, A. N. (2014). Strukturno-funktsional'noe sostoyanie miokarda, variabel'nost' ritma i elektrofiziologicheskie svoistva serdtsa u bol'nykh s paroksizmal'noi fibrillyatsiei predserdii razlichnoi etiologii [Structural and functional condition of myocardium, heart rate variability and electrophysiological heart properties in patients with paroxysmal atrial fibrillation of different genesis]. Ukrainskyi kardiolohichnyi zhurnal, (4), 84-93. [in Ukrainian].

Aparina, O. P., Chikhireva, L. N., Mironova, N. A., Mironova, E. S., & Bakalov, S. A. (2014). Rol' izmenenii struktury i funktsii predserdii v razvitii i progressirovanii fibrillyatsii predserdii [Role of atrial structural and functional changes in the development and progression of atrial fibrillation]. Terapevticheskii arkhiv, 86(1), 71-77. [in Russian].

Akramova, E. G. (2019). Klinicheskaya znachimost' prodol'noi deformatsii levogo zheludochka pri ishemicheskoi bolezni serdtsa i nekoronarogennoi patologii [Clinical significance of left ventricular longitudinal deformation in coronary heart disease and non-coronary pathology]. Kazanskii meditsinskii zhurnal, 100(2), 295-302. https://doi.org/10.17816/KMJ2019-295 [in Russian].

Friedman, D. J., Piccini, J. P., Wang, T., Zheng, J., Malaisrie, S. C., Holmes, D. R., Suri, R. M., Mack, M. J., Badhwar, V., Jacobs, J. P., Gaca, J. G., Chow, S. C., Peterson, E. D., & Brennan, J. M. (2018). Association Between Left Atrial Appendage Occlusion and Readmission for Thromboembolism Among Patients With Atrial Fibrillation Undergoing Concomitant Cardiac Surgery. JAMA, 319(4), 365-374. https://doi.org/10.1001/jama.2017.20125

Sepehri Shamloo, A., Bollmann, A., Dagres, N., Hindricks, G., & Arya, A. (2020). Natriuretic peptides: biomarkers for atrial fibrillation management. Clinical Research in Cardiology, 109(8), 957-966. https://doi.org/10.1007/s00392-020-01608-x

Borre, E. D., Goode, A., Raitz, G., Shah, B., Lowenstern, A., Chatterjee, R., Sharan, L., Allen LaPointe, N. M., Yapa, R., Davis, J. K., Lallinger, K., Schmidt, R., Kosinski, A., Al-Khatib, S. M., & Sanders, G. D. (2018). Predicting Thromboembolic and Bleeding Event Risk in Patients with Non-Valvular Atrial Fibrillation: A Systematic Review. Thrombosis and Haemostasis, 118(12), 2171-2187. https://doi.org/10.1055/s-0038-1675400

Ridker, P. M., Libby, P., MacFadyen, J. G., Thuren, T., Ballantyne, C., Fonseca, F., Koenig, W., Shimokawa, H., Everett, B. M., & Glynn, R. J. (2018). Modulation of the interleukin-6 signalling pathway and incidence rates of atherosclerotic events and all-cause mortality: analyses from the Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). European Heart Journal, 39(38), 3499-3507. https://doi.org/10.1093/eurheartj/ehy310

Bubeshka, D. A., Snezhitskiy, V. A., & Shulika, V. R. (2017). Biomarkery vospaleniya u patsientov s neklapannoi fibrillyatsiei predserdii i sistolicheskoi disfunktsiei levogo zheludochka [Biomarkers of inflammation in patients with nonvalvular atrial fibrillation and left ventricular systolic dysfunction]. Meditsinskie novosti, (4), 69-72. http://www.mednovosti.by/journal.aspx?article=7987 [in Russian].

Fushtey, I. M., Podluzhnyi, S. G., & Sid’, E. V. (2020). Effect of RAAS genes polymorphism for recurrence of paroxysmal atrial fibrillation among patients with coronary heart disease combined with hypertension. Biological Markers and Guided Therapy, 7(1), 25-30. https://doi.org/10.12988/bmgt.2020.91016

Podluzhnyi, S. G. (2020). Rivni anhiotenzynu II v zalezhnosti vid polimorfizmiv A1166S, T174M u patsiientiv z paroksyzmalnoiu fibryliatsiieiu peredserd na tli IKhS ta hipertonichnoi khvoroby [Angiothiesin II Levels depending on Polymorphisms A1166C, T174M in Patients with Paroxysmal Atrial Fibrillation on the Background of Coronary Heart Disease and Hypertension]. Ukrainskyi zhurnal medytsyny, biolohii ta sportu, 5(4), P. 209-213. https://doi.org/10.26693/jmbs05.04.209 [in Ukrainian].

Podluzhnyi, S. G., Fushtey, I. M., & Sid’, E. V. (2020, September 16-18). The relative risk of left ventricular remodeling among patients with paroxysmal atrial fibrillation by gene polymorphisms renin-angiotensin-aldosterone system. Scientific Horizon in the Context of Social Crises. Proceedings of the 6th International Scientific and Practical Conference, (2), 87-89. SPC InterConf. https://ojs.ukrlogos.in.ua/index.php/interconf/article/view/4586

Getman, T. V. (2013). Znachimost' i printsipy farmakologicheskoi korrektsii aktivnosti renin-angiotenzinovoi sistemy v terapii pri fibrillyatsii predserdii [Importance and principles of pharmacological correction of renin-angiotensin system in the treatment of atrial fibrillation]. Ukrainskyi revmatolohichnyi zhurnal, (4), 105-110. [in Russian].

Published

2021-10-29

How to Cite

1.
Kyselov SM. Current concepts on predictors of atrial fibrillation occurrence and progression. Zaporozhye Medical Journal [Internet]. 2021Oct.29 [cited 2024Oct.5];23(6):845-50. Available from: http://zmj.zsmu.edu.ua/article/view/232397

Issue

Section

Review