title: Heart Failure With Preserved Ejection Fraction and Atrial Fibrillation: Vicious Twins.
abstract: Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are age-related conditions that are increasing in prevalence, commonly coexist, and share clinical features. This review provides a practical update on the epidemiology, pathophysiology, diagnosis, and management of patients with concomitant HFpEF and AF. Epidemiological studies highlight the close and complex links between HFpEF and AF, the shared risk factors, the high AF occurrence in the natural history of HFpEF, and the independent contribution of each condition to poor outcomes. Diagnosis of HFpEF in the setting of AF is challenging because the symptoms overlap. AF is associated with changes in echocardiographic parameters and circulating natriuretic peptides that confound HFpEF diagnosis. Symptomatic improvement with diuretic therapy supports the presence of HFpEF in patients with concomitant AF. Important knowledge gaps need to be addressed by a multidisciplinary and translational research approach to develop novel therapies that can improve prognosis.
authors.affiliation: Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Dipak
authors.initials: D
authors.lastname: Kotecha
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore.
authors.forename: Carolyn S P
authors.initials: CS
authors.lastname: Lam
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Van Veldhuisen
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Isabelle C
authors.initials: IC
authors.lastname: Van Gelder
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: m.rienstra@umcg.nl.
authors.forename: Michiel
authors.initials: M
authors.lastname: Rienstra
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology*; D004452:Echocardiography; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology
keywords: age; diagnosis; epidemiology; natriuretic peptides; outcomes