Impact of Atrial Fibrillation Type on Quality of Life and Clinical Parameters in Patients with Diabetes Mellitus

心房颤动类型对糖尿病患者生活质量和临床参数的影响

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Abstract

BACKGROUND: Atrial fibrillation (AF) is a prevalent condition with a major influence on patients' quality of life, especially when blood glucose and heart rate are disrupted and systemic inflammation is present. OBJECTIVE: This study aimed to compare Kansas City Cardiomyopathy Questionnaire (KCCQ) scores of diabetic patients by AF type and their correlations with different clinical and biological parameters. MATERIAL AND METHODS: The retrospective study included 220 patients, from which only 200 were selected because of missing data. Patients were divided into three groups: paroxysmal AF (n = 49), persistent AF (n = 54), and permanent AF (n = 97). Demographic, clinical, and analytical data, echocardiographic parameters, heart rate, blood glucose, renal function, and inflammatory markers were compared between the three groups and their relationship with KCCQ scores. RESULTS: The KCCQ score was significantly higher in patients with paroxysmal AF (69.50 ± 5.93), compared to persistent AF (56.92 ± 3.04) and permanent AF (42.28 ± 5.89), p < 0.001. In subanalyses, based on left ventricular ejection fraction (LVEF), the same trend was maintained, with lower KCCQ scores associated with more severe forms of AF. Significant negative correlations of the KCCQ score with blood glucose level (r = -0.2535, p = 0.0003), heart rate (r = -0.3071, p < 0.0001), and neutrophil-lymphocyte ratio (NLR) (r = -0.2395, p = 0.0006), and a positive correlation with glomerular filtration rate (GFR) (r = 0.4349, p < 0.0001) were identified. CONCLUSIONS: The type of atrial fibrillation significantly influences the quality of life assessed by the KCCQ score. Clinical and analytical parameters such as blood glucose, heart rate, systemic inflammation, and renal function significantly correlate with patients' perception of health, indicating the importance of integrated management of AF.

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