title: [Clinical, echocardiographic and prognostic evaluation of atrial fibrillation in patients with heart failure].
abstract: OBJECTIVE
  We aimed to assess the prevalence of atrial fibrillation (AF) in a general heart failure (HF) population admitted to a HF unit, analyze the parameters associated with AF, and evaluate its prognostic significance.
  
  
  METHODS
  389 patients, 64 with AF at the first visit. Mean (SD) age was 65.38 (10.77) years and 72.5% were men. The main etiology was ischemic heart disease (59.9%). Mean ejection fraction (EF) was 32.25% (13%). Vital status at 2 years was available in 377 patients (97%), 314 in sinus rhythm (SR) and 63 in AF.
  
  
  RESULTS
  The prevalence of AF was 15.8%. AF was associated with: older age, female gender, valvular and hypertensive etiology, longer time since the onset of HF symptoms, higher EF, higher left atrium diameter, degree of mitral regurgitation, and lower quality of life, but not with the NYHA functional class. The 2-years mortality (16.7%) was significantly higher in patients with AF (33.3% vs 18.4%; OR = 2.20; 95% confidence interval, 1.21-4). However, when adjusted for other relevant variables such as age, NYHA functional class, ejection fraction, sex and etiology, AF did not remain as an independent prognostic factor. The strongest mortality differences between patients with AF and those with SR where observed in ischemic heart disease and dilated cardiomyopathy.
  
  
  CONCLUSIONS
  AF was associated mainly with age, valvular and hypertensive etiology, higher left atrium diameter and lower end-systolic left ventricular diameter. Two years mortality was significantly higher in patients with AF, although other parameters such as age and NYHA functional class had a higher prognostic value.
authors.affiliation: Unidad de Insuficiencia Cardíaca, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España. aurrutia@ns.hugtip.scs.es
authors.forename: Agustín
authors.initials: A
authors.lastname: Urrutia
authors.forename: Elisabet
authors.initials: E
authors.lastname: Zamora
authors.forename: Josep
authors.initials: J
authors.lastname: Lupón
authors.forename: Beatriz
authors.initials: B
authors.lastname: González
authors.forename: Dolores
authors.initials: D
authors.lastname: Más
authors.forename: Teresa
authors.initials: T
authors.lastname: Pascual
authors.forename: Salvador
authors.initials: S
authors.lastname: Altimir
authors.forename: Crisanto
authors.initials: C
authors.lastname: Díez
authors.forename: Celestino
authors.initials: C
authors.lastname: Rey-Joly
authors.forename: Vicente
authors.initials: V
authors.lastname: Valle
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D014463:Ultrasonography