HFpEF and atrial fibrillation : the enigmatic interplay of dysmetabolism, biomarkers, and vascular endothelial dysfunction
ID Bosanac, Jure (Author), ID Straus, Lara (Author), ID Novaković, Marko (Author), ID Košuta, Daniel (Author), ID Božič, Mojca (Author), ID Tasič, Jerneja (Author), ID Jug, Borut (Author)

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Background: Heart failure with preserved ejection fraction (HFpEF) has a complex pathophysiology that encompasses systemic proinflammatory state and dysregulated levels of cardiometabolic and oxidative stress biomarkers. The prevalence of both HFpEF and atrial fibrillation (AF) is continuously rising, especially in the elderly. The aim of our study was to explore if there were any differences in biomarker levels and vascular function in the elderly patients with HFpEF with and without AF and to assess interconnections between clinically relevant biomarkers and cardiac and vascular function. Methods: This was a cross-sectional study of patients ≥ 65 years with HFpEF who were divided into 2 groups based on the presence or absence of AF. We have sonographically assessed echocardiographic parameters of left ventricular systolic and diastolic function and the peripheral vascular function parameters, namely, pulse wave velocity (PWV) and flow-mediated dilation (FMD). NT-proBNP, irisin, leptin, adiponectin, insulin-like growth factor 1 (IGF-1), and malondialdehyde (MDA) blood levels were determined. Results: Fifty-two patients (mean age 80 ± 7 years, 67% females) were included. Patients with HFpEF and AF had significantly lower levels of irisin (median 4.75 vs. 13.5 ng/mL, p = 0.007), leptin (median 9.5 vs. 15.0 ng/L, p = 0.023), and MDA (median 293 vs. 450 ng/mL, p = 0.017) and significantly higher values of NT-proBNP (median 2365 vs. 529 ng/L, p < 0.001) but not vascular function parameters, as compared to HFpEF patients without AF. MDA was significantly correlated with diastolic function (r = 0.395, p = 0.007) and FMD (r = 0.394, p = 0.011), while adiponectin was inversely associated with FMD (r = –0.325, p = 0.038) and left ventricular ejection fraction (r = –0.319, p = 0.029). Conclusions: Our results have demonstrated that patients with HFpEF and AF have significantly lower leptin, irisin, and MDA levels compared to patients with HFpEF but without AF. These results offer new insights into the complexity of vascular function and cardiometabolic and oxidative stress biomarkers in the context of HFpEF, AF, and aging.

Keywords:atrial fibrillation, heart failure, ejection fraction
Work type:Article
Typology:1.01 - Original Scientific Article
Organization:MF - Faculty of Medicine
Publication status:Published
Publication version:Version of Record
Number of pages:7 str.
Numbering:Vol. 2022, art. 9539676
PID:20.500.12556/RUL-152338 This link opens in a new window
ISSN on article:1875-8630
DOI:10.1155/2022/9539676 This link opens in a new window
COBISS.SI-ID:141947139 This link opens in a new window
Publication date in RUL:21.11.2023
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Title:Disease markers
COBISS.SI-ID:516120089 This link opens in a new window


License:CC BY 4.0, Creative Commons Attribution 4.0 International
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

Keywords:atrijska fibrilacija, srčno popuščanje, iztisni delež


Funder:Other - Other funder or multiple funders
Funding programme:University Medical Centre Ljubljana, Intern tertiary grant

Funder:ARRS - Slovenian Research Agency
Project number:P3-0308
Name:Ateroskleroza in tromboza

Funder:ARRS - Slovenian Research Agency
Project number:V3-2104
Name:Sekundarna preventiva in kakovosti oskrbe po srčnem infarktu v slovenskih bolnišnicah ter analiza vpliva epidemije covid-19 na obravnavo aterosklerotične bolezni

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