Related Experiment Video

Updated: Jul 11, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

Impact of atrial fibrillation in heart failure with normal ejection fraction: a clinical and echocardiographic study

Jeffrey W H Fung1, John E Sanderson, Gabriel W K Yip

  • 1Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Journal of Cardiac Failure
|October 10, 2007
PubMed

Insights

Atrial fibrillation (AF) in heart failure with normal ejection fraction (HFNEF) is linked to worse diastolic dysfunction and poorer clinical outcomes, including higher rates of hospitalization and death, compared to HFNEF patients in sinus rhythm.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • The clinical impact of atrial fibrillation (AF) in heart failure with normal ejection fraction (HFNEF) is not well-defined.
  • HFNEF represents a significant patient population with distinct pathophysiology.

Purpose of the Study:

  • To investigate the clinical significance and outcomes of AF in patients diagnosed with HFNEF.
  • To compare HFNEF patients with and without AF regarding clinical characteristics, diastolic function, and prognosis.

Main Methods:

  • A comparative study of 238 hospitalized heart failure patients, categorizing them into HFNEF (EF ≥ 50%) and systolic HF (EF < 50%).
  • Clinical, echocardiographic, and functional status data were analyzed, with a focus on comparing HFNEF patients with and without AF.
  • Follow-up data were collected to assess recurrent hospitalizations and mortality.

Main Results:

  • HFNEF patients with AF exhibited worse New York Heart Association class, reduced 6-minute walk distance, and poorer quality of life compared to those in sinus rhythm.
  • Patients with HFNEF and AF demonstrated more severe diastolic dysfunction.
  • The incidence of recurrent heart failure hospitalization or death was significantly higher in HFNEF patients with AF (28.6%) versus sinus rhythm (10.6%).

Conclusions:

  • Atrial fibrillation in HFNEF is associated with increased diastolic dysfunction severity.
  • AF and restrictive diastolic dysfunction are independent predictors of adverse outcomes, including hospitalization or death, in HFNEF patients.
  • These findings highlight the importance of managing AF in HFNEF to improve patient prognosis.
Abstract

More Related Videos

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...