Key result
AF in HFpEF is linked to ~4-point lower left atrial reservoir strain.
Why the study?
Atrial fibrillation is associated with worse prognosis in HFpEF patients, but mechanisms contributing to this adverse outcome are not fully understood.
Does atrial fibrillation worsen atrial function and affect clinical outcomes in patients with HFpEF?
Cohort (n=95)
Does atrial fibrillation worsen atrial function and affect clinical outcomes in patients with HFpEF?
In patients with HFpEF, pre-existing atrial fibrillation is associated with significantly impaired left atrial reservoir and pump function, reflecting compromised atrial contraction.
Answers are grounded in this paper and cite their sources.
AF-associated LA strain impairment in HFpEF may reflect worse atrial function; leaves open whether it mediates outcomes or guides therapy.
Background Atrial fibrillation (AF) is associated with a worse prognosis in heart failure with preserved ejection fraction (HFpEF) patients. This study investigates the potential mechanisms contributing to this adverse outcome. Methods We performed a retrospective review of patients hospitalized for acute heart failure from 2014 to 2023, assessing echocardiographic findings and clinical characteristics of those with and without AF. Results The study included 95 patients, 39 (54%) of whom had AF before hospitalization. Baseline characteristics were similar between both groups. Patients without AF had significantly higher left atrial reservoir strain (LASr) (21.20 ± 9.2 vs 17.32 ± 7.2; p = 0.02) and pump strain (LASp) (9.32 ± 7.0 vs 4.93 ± 2.8; p < 0.0001). Additionally, tricuspid sʼ velocity was significantly higher in patients without AF. However, no significant differences were observed in clinical outcomes during the 13-month follow-up period. Conclusion Among HFpEF patients, the presence of AF is associated with greater atrial dysfunction, as indicated by lower LASr and LASp values, reflecting both impaired atrial contraction and compromised reservoir function.
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Puwatnuttasit et al. (2025) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=95). Atrial fibrillation (AF) vs. Patients without AF was evaluated on Left atrial reservoir strain (LASr) (p=0.02). In HFpEF patients, the presence of atrial fibrillation was associated with significantly lower left atrial reservoir strain (17.32 vs 21.20; P=0.02) and pump strain (4.93 vs 9.32; P<0.0001).
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