title: Congestive heart failure with and without atrial fibrillation - different patient populations?
abstract: OBJECTIVE
  Heart failure (HF) and atrial fibrillation (AF) are common comorbid conditions in hospitalised patients. AF may occur when left ventricular (LV) systolic function deteriorates. The aim was to compare HF patients with AF to patients in sinus rhythm (SR).
  
  
  METHODS
  Echocardiography and a cardiopulmonary exercise test were performed in 67 patients with HF. Peak VO(2) was determined, as were LV-mass, enddiastolic, endsystolic volume indices (EDVI, ESVI), and ejection fraction (EF).
  
  
  RESULTS
  EF tended to be higher in AF compared to SR patients (39+/-10 vs. 31+/-10%), LV volume indices were smaller (ESVI:35+/-19 vs. 59+/-25 ml/m(2), p<0.0001, EDVI:56+/-24 vs. 83+/-29 ml/m(2), p<0.001). LV hypertrophy was prevalent (59% vs. 63%) and concentric hypertrophy tended to be more common with AF (50% vs. 21%). Peak VO(2) was similarly reduced in AF and SR (11.4+/-3.2 vs. 12.1+/-4.3 ml/kg*min).
  
  
  CONCLUSIONS
  HF patients with AF compared to SR tend to have smaller LV volumes, less compromised systolic function and more frequent LV concentric hypertrophy. Our study supports the concept that AF in HF indicates a different patient population rather than an effect of progressive LV systolic dysfunction.
authors.affiliation: Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. david.waldenhjort@ds.se
authors.forename: David
authors.initials: D
authors.lastname: Waldenhjort
authors.forename: Märit
authors.initials: M
authors.lastname: Mejhert
authors.forename: Magnus
authors.initials: M
authors.lastname: Edner
authors.forename: Mårten
authors.initials: M
authors.lastname: Rosenqvist
authors.forename: Hans
authors.initials: H
authors.lastname: Persson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D008297:Male; D010101:Oxygen Consumption; D012189:Retrospective Studies; D013318:Stroke Volume