학술논문
Is atrial fibrillation in HFpEF a distinct phenotype? Insights from multiparametric MRI and circulating biomarkers
Document Type
article
Author
Abhishek Dattani; Emer M. Brady; Prathap Kanagala; Svetlana Stoma; Kelly S. Parke; Anna-Marie Marsh; Anvesha Singh; Jayanth R. Arnold; Alastair J. Moss; Lei Zhao; Mary Ellen Cvijic; Matthew Fronheiser; Shuyan Du; Philippe Costet; Peter Schafer; Leon Carayannopoulos; Ching-Pin Chang; David Gordon; Francisco Ramirez-Valle; Michael Jerosch-Herold; Christopher P. Nelson; Iain B. Squire; Leong L. Ng; Gaurav S. Gulsin; Gerry P. McCann
Source
BMC Cardiovascular Disorders, Vol 24, Iss 1, Pp 1-15 (2024)
Subject
Language
English
ISSN
1471-2261
Abstract
Abstract Background Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) frequently co-exist. There is a limited understanding on whether this coexistence is associated with distinct alterations in myocardial remodelling and mechanics. We aimed to determine if patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) represent a distinct phenotype. Methods In this secondary analysis of adults with HFpEF (NCT03050593), participants were comprehensively phenotyped with stress cardiac MRI, echocardiography and plasma fibroinflammatory biomarkers, and were followed for the composite endpoint (HF hospitalisation or death) at a median of 8.5 years. Those with AF were compared to sinus rhythm (SR) and unsupervised cluster analysis was performed to explore possible phenotypes. Results 136 subjects were included (SR = 75, AF = 61). The AF group was older (76 ± 8 vs. 70 ± 10 years) with less diabetes (36% vs. 61%) compared to the SR group and had higher left atrial (LA) volumes (61 ± 30 vs. 39 ± 15 mL/m2, p