Association between the Albumin-to-Globulin Ratio and Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy

³ Beijing Anzhen Hospital, Capital Medical University, The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 100029 Beijing, China

⁴ Department of Cardiology, Beijing Jishuitan Hospital, 100029 Beijing, China

^*Correspondence: yongqianglai@yahoo.com (Yongqiang Lai); wuyongquan67@126.com (Yongquan Wu); xiaoping_zhang2004@ccmu.edu.cn (Xiaoping Zhang)
^†These authors contributed equally.

Rev. Cardiovasc. Med. 2024, 25(3), 96; https://doi.org/10.31083/j.rcm2503096

Submitted: 30 June 2023 | Revised: 1 September 2023 | Accepted: 22 September 2023 | Published: 7 March 2024

This is an open access article under the CC BY 4.0 license.

Abstract

Background: Atrial fibrillation (AF), which occurs four to six times more frequently in hypertrophic cardiomyopathy (HCM) patients than in the general population, is the most common persistent arrhythmia and has a substantial therapeutic consequence. In HCM patients, there are currently no discovered signs that could be utilized to identify AF. Methods: From 2018 to 2022, 493 individuals with a continuous diagnosis of HCM were examined at Beijing Anzhen Hospital. AF was proven using routine electrocardiography (ECG), 24-hour Holter ECGs, or bedside ECGs. Echocardiography and blood tests were performed for all patients. Analysis and comparison of the traits were performed in HCM patients with AF (n = 77) and without AF (n = 416). Results: Age (p $<$ 0.001), prevalence of ventricular tachycardia (VT, p $<$ 0.001), prevalence of pulmonary artery hypertension (p = 0.027), and albumin-to-globulin ratio (AGR, p = 0.046) were all significantly higher in patients with AF, compared to patients without AF. In multivariate logistic analysis, age (odds ratio [OR], 1.063; 95% confidence interval [CI], 1.032–1.095; p $<$ 0.001), history of VT (OR, 2.702; 95% CI, 1.007–7.255; p = 0.048), AGR (OR, 3.477; 95% CI, 1.417–8.536; p = 0.007), left atrial diameter (OR, 1.132; 95% CI, 1.073–1.194; p $<$ 0.001), left ventricular end-diastolic diameter (OR, 0.861; 95% CI, 0.762–0.974; p = 0.017), left ventricular end-systolic diameter (OR, 1.239; 95% CI, 1.083–1.417; p = 0.002), and peak A wave velocity (OR, 0.983; 95% CI, 0.972–0.994; p = 0.002) were independently associated with AF in HCM patients. In the receiver operating characteristic curve analysis, the area under the curve for the established model was 0.819 (95% CI, 0.755–0.883, p = 0.033), with a sensitivity and specificity of 0.763 and 0.816, respectively, for AF occurrence in HCM patients. Conclusions: In individuals with HCM, a history of VT and a higher AGR are independently linked to AF. Further investigation is necessary to determine whether increased AGR represents a risk factor for embolic stroke or cardiovascular death.

Keywords

hypertrophic cardiomyopathy

atrial fibrillation

albumin-to-globulin ratio

Funding

7172040/Beijing Natural Science Foundation

ZR-202212/Beijing JST Research Funding

KCZD202201/Capital Medical University Major Science and Technology Innovation Research and Development Special Fund

Figures

Fig. 1.

Previous article in this issue

Next article in this issue

Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174