Arrhythmias & electrophysiology
Prevalence and incidence of diastolic dysfunction in atrial fibrillation: clinical implications
Authors' conclusion
Patients with new-onset AF display high-risk features for HFpEF at diagnosis, emphasizing the importance of evaluating for HFpEF among symptomatic patients with AF. Patients with new-onset AF have accelerated progression in DD over time, which may identify patients with preclinical HFpEF, where preventive therapies may be tested.
Study context
- Population
- Adults with new-onset atrial fibrillation (AF) or sinus rhythm and no structural heart diseasematched 1:3
- Participants
- 1,747 vs 29,623
- Exposure
- New-onset AF vs sinus rhythm
- AFn = 1,747
- Sinus rhythm (SR)n = 29,623reference
- Outcome
- Prevalence and incidence of diastolic dysfunction (SDD: ≥3/4 abnormal parameters; ≥MDD: ≥2/4)
Methodological detailspropensity-score matched (1:3)
- Propensity-score matched (1:3)
Main finding
As reported in the abstract
Prevalence of DD
AF
- SDD
- 8%
- ≥MDD
- 25%
SR
- SDD
- 3%
- ≥MDD
- 16%
SDD
AF8%
SR3%
≥MDD
AF25%
SR16%
AF vs SRHazard ratio (95% CI)
Incident SDD
2.69(2.19–3.32)
Incident ≥MDD
1.73(1.49–2.02)
Observational data: associations, not effects.
Further findings
- Heart failure with preserved ejection fraction (HFpEF) features in AF
- 62% · High-risk H2FPEF score · Clinically recognized HFpEF 5%
Progression of diastolic dysfunction (DD) indices · median follow-up 3.2 (IQR 1.6-5.8) years
- DD progressed two-four-fold more rapidly with new-onset AF
- P < 0.001 for all
Original publication
Prevalence and incidence of diastolic dysfunction in atrial fibrillation: clinical implications. Eur Heart J. Published 28 August 2023. doi:10.
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