Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEF
Abstract Aims Inter‐atrial block (IAB), a marker of electrical atrial dysfunction, is associated with an increased risk of atrial fibrillation (AF) and adverse events in various populations. The prognostic impact of IAB in heart failure (HF) with preserved ejection fraction (HFpEF) remains unknown....
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Wiley
2025-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15179 |
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| author | Jerremy Weerts Sanne G.J. Mourmans Helena Lopez‐Martinez Mar Domingo Arantxa Barandiarán Aizpurua Michiel T.H.M. Henkens Anouk Achten Josep Lupón Hans‐Peter Brunner‐La Rocca Christian Knackstedt Antoni Bayés‐Genís Vanessa P.M. vanEmpel |
| author_facet | Jerremy Weerts Sanne G.J. Mourmans Helena Lopez‐Martinez Mar Domingo Arantxa Barandiarán Aizpurua Michiel T.H.M. Henkens Anouk Achten Josep Lupón Hans‐Peter Brunner‐La Rocca Christian Knackstedt Antoni Bayés‐Genís Vanessa P.M. vanEmpel |
| author_sort | Jerremy Weerts |
| collection | DOAJ |
| description | Abstract Aims Inter‐atrial block (IAB), a marker of electrical atrial dysfunction, is associated with an increased risk of atrial fibrillation (AF) and adverse events in various populations. The prognostic impact of IAB in heart failure (HF) with preserved ejection fraction (HFpEF) remains unknown. The aim of this study is to determine the prevalence of IAB and the association of IAB and AF with adverse events in HFpEF across different healthcare settings. Methods and results To identify electrical atrial dysfunction, baseline ECG's and medical history were analysed in HFpEF patients in an ambulatory setting and after recent HF hospitalisation. Patients were categorised into (i) HFpEFNo IAB, (ii) HFpEFIAB, or (iii) HFpEFAF. Adverse events included HF hospitalisation, cardiac/sudden death and a composite of both. The ambulatory cohort included 372 patients [mean age 75 ± 7 years, 252 (68%) females]. The recently hospitalised cohort included 132 patients [mean age 81 ± 10 years, 80 (61%) females]. Ambulatory patients included 17 (4%) HFpEFnoIAB, 114 (31%) HFpEFIAB and 241 (65%) HFpEFAF, while recently hospitalised patients included 31 (23%), 73 (55%) and 28 (21%), respectively. After 33 months of follow‐up of ambulatory patients, composite endpoints occurred in 0 (0%) HFpEFnoIAB, 12 (11%) HFpEFIAB [HR 4.1 (95% CI 0.5–522.6)] and 59 (24%) HFpEFAF patients [HR 10.1 (95% CI 1.5–1270.4), P < 0.001]. Recently hospitalised patients showed a similar trend, with composite endpoints in 10 (32%) HFpEFnoIAB, 31 (42%) HFpEFIAB (HR 1.5 [95% CI 0.7–3.1]) and 22 (79%) HFpEFAF (HR 3.8 [95% CI 1.8–8.1], P < 0.001). Conclusions Progressive stages of electrical atrial dysfunction appeared to be prognostic markers of adverse outcomes in ambulatory and recently hospitalised patients with HFpEF. Ambulatory patients with HFpEF and no early stages of electrical atrial dysfunction showed to be at very low risk for adverse outcomes. Whether such patients benefit less strict management remains to be investigated. |
| format | Article |
| id | doaj-art-59823d17fad84bc8a31e9aaebab3d7a3 |
| institution | OA Journals |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-59823d17fad84bc8a31e9aaebab3d7a32025-08-20T02:16:01ZengWileyESC Heart Failure2055-58222025-06-011232287229710.1002/ehf2.15179Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEFJerremy Weerts0Sanne G.J. Mourmans1Helena Lopez‐Martinez2Mar Domingo3Arantxa Barandiarán Aizpurua4Michiel T.H.M. Henkens5Anouk Achten6Josep Lupón7Hans‐Peter Brunner‐La Rocca8Christian Knackstedt9Antoni Bayés‐Genís10Vanessa P.M. vanEmpel11Department of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsDepartment of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsHeart Institute Hospital Universitari Germans Trias i Pujol Barcelona SpainHeart Institute Hospital Universitari Germans Trias i Pujol Barcelona SpainDepartment of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsDepartment of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsDepartment of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsHeart Institute Hospital Universitari Germans Trias i Pujol Barcelona SpainDepartment of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsDepartment of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsHeart Institute Hospital Universitari Germans Trias i Pujol Barcelona SpainDepartment of Cardiology Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre+ (MUMC+) Maastricht The NetherlandsAbstract Aims Inter‐atrial block (IAB), a marker of electrical atrial dysfunction, is associated with an increased risk of atrial fibrillation (AF) and adverse events in various populations. The prognostic impact of IAB in heart failure (HF) with preserved ejection fraction (HFpEF) remains unknown. The aim of this study is to determine the prevalence of IAB and the association of IAB and AF with adverse events in HFpEF across different healthcare settings. Methods and results To identify electrical atrial dysfunction, baseline ECG's and medical history were analysed in HFpEF patients in an ambulatory setting and after recent HF hospitalisation. Patients were categorised into (i) HFpEFNo IAB, (ii) HFpEFIAB, or (iii) HFpEFAF. Adverse events included HF hospitalisation, cardiac/sudden death and a composite of both. The ambulatory cohort included 372 patients [mean age 75 ± 7 years, 252 (68%) females]. The recently hospitalised cohort included 132 patients [mean age 81 ± 10 years, 80 (61%) females]. Ambulatory patients included 17 (4%) HFpEFnoIAB, 114 (31%) HFpEFIAB and 241 (65%) HFpEFAF, while recently hospitalised patients included 31 (23%), 73 (55%) and 28 (21%), respectively. After 33 months of follow‐up of ambulatory patients, composite endpoints occurred in 0 (0%) HFpEFnoIAB, 12 (11%) HFpEFIAB [HR 4.1 (95% CI 0.5–522.6)] and 59 (24%) HFpEFAF patients [HR 10.1 (95% CI 1.5–1270.4), P < 0.001]. Recently hospitalised patients showed a similar trend, with composite endpoints in 10 (32%) HFpEFnoIAB, 31 (42%) HFpEFIAB (HR 1.5 [95% CI 0.7–3.1]) and 22 (79%) HFpEFAF (HR 3.8 [95% CI 1.8–8.1], P < 0.001). Conclusions Progressive stages of electrical atrial dysfunction appeared to be prognostic markers of adverse outcomes in ambulatory and recently hospitalised patients with HFpEF. Ambulatory patients with HFpEF and no early stages of electrical atrial dysfunction showed to be at very low risk for adverse outcomes. Whether such patients benefit less strict management remains to be investigated.https://doi.org/10.1002/ehf2.15179Atrial dysfunctionAtrial fibrillationElectrocardiographyHeart atriaHeart failure with preserved ejection fractionPrognosis |
| spellingShingle | Jerremy Weerts Sanne G.J. Mourmans Helena Lopez‐Martinez Mar Domingo Arantxa Barandiarán Aizpurua Michiel T.H.M. Henkens Anouk Achten Josep Lupón Hans‐Peter Brunner‐La Rocca Christian Knackstedt Antoni Bayés‐Genís Vanessa P.M. vanEmpel Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEF ESC Heart Failure Atrial dysfunction Atrial fibrillation Electrocardiography Heart atria Heart failure with preserved ejection fraction Prognosis |
| title | Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEF |
| title_full | Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEF |
| title_fullStr | Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEF |
| title_full_unstemmed | Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEF |
| title_short | Inter‐atrial block as a predictor of adverse outcomes in patients with HFpEF |
| title_sort | inter atrial block as a predictor of adverse outcomes in patients with hfpef |
| topic | Atrial dysfunction Atrial fibrillation Electrocardiography Heart atria Heart failure with preserved ejection fraction Prognosis |
| url | https://doi.org/10.1002/ehf2.15179 |
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