Differential Prognostic Impact of Atrial Fibrillation in Hospitalized Heart Failure Patients With Preserved Ejection Fraction According to Coronary Artery Disease Status　― Report From the Japanese Nationwide Multicenter Registry ―

Abstract

geneity of HFpEF and are very important not only in the development of HFpEF, but also in the development of subsequent adverse events. 10,11 Despite HFpEF being a heterogeneous syndrome, most previous studies have dealt with all phenotypes of HFpEF in a similar manner. 12 In fact, the prognostic value of AF has been evaluated only in the whole HFpEF cohort, without subgroup analyses in each specific comorbidity. 6,13,14 This delays the characterization of HFpEF patients in whom AF may have a greater H eart failure (HF) with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are coexisting conditions. The prevalence of HFpEF in AF is high, at around 20%, 1,2 and the prevalence of AF in HFpEF is as high as 32-61.5%. 3-5 AF is also an independent prognostic determinant in patients with HF. 6,7 Notably, the development of AF may have more unfavorable effects on clinical outcomes in patients with HFpEF than in those with HF with reduced ejection fraction (HFrEF). 8,9 Other comorbid conditions in HFpEF, such as hypertension, diabetes, obesity, chronic obstructive pulmonary disease, and coronary artery disease (CAD), result in hetero-Editorial p 374

Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction

“…This discrepancy may be attributed to the different baseline characteristics of prior cohorts, namely, older age, higher comorbidity burden, and worse cardiac function with frailer patients. These characteristics would predispose to the patients to higher rates of death (28)(29)(30)(31)(32)(33).…”

Catheter Ablation for Atrial Fibrillation in Patients with Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

“…Unlike HFrEF, treatment options are more limited with diuretic therapy and mineralocorticoid antagonists representing the mainstay [11]. A concomitant diagnosis of AF appears to worsen outcomes more than either condition alone, and the data pertaining to the management of AF in patients with HFpEF is somewhat controversial [12]. Although catheter ablation (CA) success rates are limited in that approximately 60% or more for paroxysmal atrial fibrillation and 30% or less for persistent atrial fibrillation after a single procedure, success rates increase for multiple procedures.…”

Machine learning for atrial fibrillation risk prediction in patients with sleep apnea and coronary artery disease

“…Similarly, AF is present in 17–47% of patients with CAD while the prevalence of CAD in patients with AF has been reported from 0.2 to 5% ( 39 ). AF has worse clinical outcomes in patients with preserved ejection fraction without CAD compared to those with CAD ( 40 ). Further studies are necessary to investigate the biological mechanisms involved in the AF and CAD relationship.…”