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Cardiac arrhythmias in highlanders with a diagnosis of chronic cor pulmonale
Ricardo Sosa-Villarreal1, José M Arce-Carreón2
1Departamento de Cardiología. Instituto Nacional de Tórax. La Paz, Bolivia.
Insights
Chronic cor pulmonale (CPC) is increasingly seen in high-altitude populations. This study found atrial fibrillation to be the most frequent arrhythmia in CPC patients, with erythrocytosis and right atrial dilation as key risk factors.
Area of Science:
- Cardiology
- Pulmonology
- High-altitude physiology
Background:
- Chronic cor pulmonale (CPC) prevalence is rising among individuals residing at high altitudes.
- Understanding the cardiac implications of CPC in these populations is crucial.
Purpose of the Study:
- To determine the frequency of cardiac arrhythmias in patients with CPC.
- To identify significant risk factors associated with the development of these arrhythmias.
Main Methods:
- A descriptive, cross-sectional study was conducted.
- Data from 162 inpatients diagnosed with CPC (defined by clinical, ECG, and echocardiographic criteria) at the National Institute of Torax, La Paz, Bolivia, between January 2017 and June 2018 were analyzed.
- Statistical analysis included Student's t-test and ANOVA.
Main Results:
- Atrial fibrillation (AF) was the most common arrhythmia, occurring in 75% of patients.
- Univariate analysis identified erythrocytosis, pulmonary arterial hypertension, right atrial dilation, obesity, and systemic arterial hypertension as significant risk factors.
- Multivariate analysis confirmed erythrocytosis (RR: 2.2) and right atrial dilation (RR: 1.2) as statistically significant risk factors for arrhythmias in CPC patients.
Conclusions:
- Atrial fibrillation is highly prevalent in patients with chronic cor pulmonale.
- Erythrocytosis and right atrial dilation are the most significant statistical risk factors for developing arrhythmias in this patient group.
Antecedentes:
El corazón pulmonar crónico (CPC) muestra un incremento en habitantes que viven en grandes altitudes.
Objetivo:
Investigar la frecuencia de arritmias cardíacas y factores de riesgo para su desarrollo.
MéTodos:
Estudio descriptivo y transversal; se revisó el registro de pacientes internados del Departamento de Cardiología del Instituto Nacional de Tórax, La Paz, Bolivia, entre enero de 2017 y junio de 2018; se incorporó a todos los individuos con diagnóstico de CPC, definido por criterios clínicos, electrocardiográficos y ecocardiográficos; se incluyó a 162 pacientes que cumplieron los criterios en el análisis; se utilizaron la t de Student y ANOVA.
Resultados:
Arritmias: fibrilación auricular (FA), 125 (75%); aleteo auricular (AA), 17 (10.5%); taquicardia auricular (TA), 17 (10.5%); extrasístoles, 3 (1.9%). Según el análisis univariado, los factores relacionados con el desarrollo de arritmias fueron: eritrocitosis: FA, RR: 1.33, otras arritmias (RR: 1.67), p = 0.0001; hipertensión arterial pulmonar: FA, RR: 3.10, otras arritmias (RR: 3.21), p = 0.0001; dilatación de aurícula derecha (AD): FA, RR: 1.92, otras arritmias (RR: 2.13), p = 0.0001; obesidad: FA, RR: 3.47, p = 0.001, otras arritmias (RR: 3.70), p = 0.001; hipertensión arterial sistémica: FA, RR: 3.10, p = 0.001, otras arritmias (RR: 3.21), p = 0.001. Según el análisis multivariado: eritrocitosis (RR: 2.2), dilatación de AD (RR: 1.2), p = 0.0001.
Conclusiones:
Se encontró FA con mayor frecuencia en los pacientes con CPC; los factores de riesgo con mayor significancia estadística para su presentación fueron la eritrocitosis y la dilatación de la AD.
Background:
Chronic cor pulmonale (CPC), with increased presentation in high-altitude inhabitants.
Objectives:
Investigating the frequency of cardiac arrhythmias, and risk factors for its development.
Methods:
Descriptive, cross-sectional study, the inpatient registry of the Department of Cardiology of the National Institute of Torax, La Paz-Bolivia, from January 2017 to June 2018 was reviewed, all were incorporated with the diagnosis of CPC, defined by clinical criteria, electrocardiographic and echocardiographic, 162 patients who met the criteria were taken, the student’s t-test and ANOVA were used for the analysis.
Results:
Arrhythmias: atrial fibrillation (AF) 125 (75%), atrial flutter (AA) 17 (10.5%), atrial tachycardia (AT) 17 (10.5%), extrasystoles 3 (1.9%). Univariate analysis of factors related to the development of arrhythmias: erythrocytosis: FA, RR: 1.33, other arrhythmias RR: 1.67, p = 0.0001, pulmonary arterial hypertension: FA, RR: 3.10, other arrhythmias RR: 3.21, p = 0.0001, right atrial dilation (AD): FA, RR: 1.92, other arrhythmias RR: 2.13, p = 0.0001, obesity: FA, RR: 3.47, p = 0.001, other arrhythmias RR: 3.70, p = 0.001, systemic arterial hypertension: FA: RR: 3.10, p = 0.001, other arrhythmias RR: 3.21, p = 0.001. Multivariate analysis: erythrocytosis (RR: 2.2), AD dilation (RR: 1.2), p = 0.0001.
Conclusions:
AF was found more frequently in patients with CPC, the risk factors with the greatest statistical significance for presentation were: erythrocytosis and AD dilation.
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