الفهرس 
Chapter (1) ATRIAL FIBRILLATIONOnly 14 pages are availabe for public view
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Abstract
This study was conducted in order to find out the incidence of atrial fibrillation in ischemic and nonischemic cardiomyopathy patients and risk factors affecting, the prevalence of AF among these groups of patients. Fifty patients were included in our study. The mean age of the whole cohort was 61.04±13.7 years; there were 48 males (96%), 2 females (4%), and the mean body mass index was 27.46±3.30kg/m2. There were 33 (66%) diabetics, 26 (52%) hypertensive, 26 (52%) Dyslipidemic, 35 (43.3%) smokers, and 19 (38%) had atrial fibrillation. All patients had left ventricular ejection fractions (EFs) < 45% and were clinically stable, without the need for hospital admission or intravenous vasoactive agents, with LVEDd > 27 mm/m2BSA are included in the study. Patients who had valvular disease prosthetic valve, congenital heart disease, with any cardiac revascularization procedure <30 days before enrollment and hospitalization for myocardial infarction, unstable angina, within the past 3 months were excluded from the study.
All patients underwent complete evaluation at their visit in the Cardiology Department, including accurate clinical history, physical examination, 12-lead electrocardiogram (ECG), echocardiogram, and coronary angiogram, for diagnosis of AF and to differentiate between ischemic and non-ischemic DCM. NIDCM group, 20 patients (40%), and IDCM group, 30 patients (60%).
An ischemic dilated cardiomyopathy group of patients had significantly more frequent DM, dyslipidemia compared with non-ischemic dilated cardiomyopathy (p<0.05 of both).
AF more frequent in ischemic dilated cardiomyopathy group compared with nonischemic dilated cardiomyopathy group (p=0.006). Among this group the mean LA diameter was significantly higher (5.127±0.798 versus 4.680±0.626) (p=0.03). There was no significant difference between the two groups regarding the mean of other findings LVEDd, LVESd and EF (P > 0.05 for both).
The univariate analysis identified the following as predictors of AF incidence in DCM patients IDCM, DM, dyslipidemia, and increase in LA diameter (p<0.05 for all).
Multivariate regression analysis utilizing all variables (DM, dyslipidemia, LVEDd, LA diameter, and IDCM) as independent predictors against AF incidence as a dependent variable. It identified that there were DM, dyslipidemia, and increase in LA diameter had a more independent predictor function of atrial fibrillation among dilated cardiomyopathy patients in spite of the aetiological cause of dilated cardiomyopathy.
ROC curve has shown that, DM and dyslipidemia predicts AF incidence with (sensitivity 90.4%, specificity 84.4%) (sensitivity 74.6%, specificity 61.3%) respectively. Also LA diameter predicts AF incidence with (sensitivity 95.6%, specificity 71%, and cutoff value of LA diameter that best predicts AF incidence was>4.8 cm).