Heart failure, diastolic dysfunction and atrial fibrillation; mechanistic insight of a complex inter-relationship

Area of Science:

• Cardiology
• Clinical Medicine
• Pathophysiology

Background:

• Atrial fibrillation (AF) and heart failure (HF) frequently coexist, leading to adverse outcomes like thromboembolism, disease progression, hospitalization, and death.
• Diastolic dysfunction (DD) is common in HF patients and independently predicts hospitalization and mortality, and it strongly predicts incident AF in HF patients.

Purpose of the Study:

• To provide mechanistic insights into the pathophysiology linking AF, HF, and DD.
• To outline the complex inter-relationships between AF, DD, and HF.
• To examine the impact of asymptomatic paroxysmal atrial fibrillation (PAF) in HF patients.

Main Methods:

• Literature review focusing on pathophysiological mechanisms.
• Analysis of existing studies on the interplay between AF, HF, and DD.
• Examination of invasive study findings regarding asymptomatic PAF in HF.

Main Results:

• The review elucidates the pathophysiological processes driving AF, HF, and DD.
• A complex, reciprocal relationship ('yin-yang') between AF, DD, and HF is described.
• Asymptomatic paroxysmal atrial fibrillation (PAF) is a common finding in HF patients.

Conclusions:

• Understanding the intricate connections between AF, HF, and DD is crucial for managing patients.
• The clinical significance of undiagnosed PAF in HF patients warrants further investigation.
• Targeting these interconnected conditions may improve patient outcomes.