Introduction
Methods
Study design and participants
Assessments
Blood sampling
Functional assessment
TTE
CMR imaging
CMR analysis
Clinical follow up
Statistical analysis
Cluster analysis
Patient outcome data
Results
Baseline characteristics
Sinus rhythm (n = 75) | AF (n = 61) | P value | |
---|---|---|---|
Age, years | 70 ± 10 | 76 ± 8 | < 0.001 |
Sex, n (%) female | 39 (52) | 30 (49) | 0.744 |
Ethnicity | 0.023 | ||
White, n(%) | 57 (76) | 57 (93) | |
South Asian, n(%) | 14 (19) | 3 (5) | |
Black and Other, n(%) | 4 (5) | 1 (2) | |
Height, cm | 163 ± 9 | 165 ± 10 | 0.203 |
Weight, kg | 92 ± 20 | 90 ± 19 | 0.508 |
BMI, kg/m2 | 35 ± 7 | 33 ± 7 | 0.143 |
Heart rate, bpm | 68 [59–82] | 67 [59–78] | 0.524 |
SBP, mmHg | 147 ± 27 | 143 ± 23 | 0.426 |
DBP, mmHg | 73 [62–80] | 75 [68–83] | 0.072 |
History, n (%) | |||
Hypertension | 69 (92) | 54 (89) | 0.493 |
Hyperlipidaemia | 40 (53) | 27 (44) | 0.293 |
Diabetes | 46 (61) | 22 (36) | 0.003 |
IHD | 19 (25) | 17 (28) | 0.739 |
Smoking | 38 (51) | 34 (56) | 0.556 |
COPD | 9 (12) | 9 (15) | 0.637 |
Previous HF hospitalisation | 52 (69) | 38 (62) | 0.388 |
Medications, n (%) | |||
ACEi | 46 (61) | 29 (48) | 0.108 |
ARB | 23 (31) | 19 (31) | 0.952 |
Beta blocker | 45 (60) | 47 (77) | 0.035 |
Dihydropyridine CCB | 25 (33) | 14 (23) | 0.183 |
Non-dihydropyridine CCB | 2 (3) | 4 (7) | 0.272 |
Digoxin | 0 (0) | 11 (18) | < 0.001 |
Amiodarone | 0 (0) | 2 (3) | 0.114 |
Diuretic | 59 (79) | 50 (82) | 0.631 |
Statin | 50 (67) | 36 (59) | 0.357 |
Metformin | 22 (29) | 12 (20) | 0.196 |
Sulphonylurea | 6 (8) | 5 (8) | 0.967 |
Insulin | 17 (23) | 6 (10) | 0.047 |
eGFR, mL/min/1.73m2 | 60 [46–83] | 69 [56–83] | 0.079 |
HbA1c, % | 6.4 [5.8–7.4] | 6.0 [5.7–6.8] | 0.378 |
BNP, ng/L | 111 [43–249] | 159 [92–271] | 0.044 |
Functional Status | |||
NYHA Class I/II, n (%) | 50 (67) | 44 (72) | 0.493 |
NYHA Class III/IV, n (%) | 25 (33) | 17 (28) | 0.493 |
6MWT distance, m | 192 ± 91 | 200 ± 93 | 0.615 |
Minnesota living with HF score | 48 ± 24 | 43 ± 22 | 0.214 |
HFA-PEFF score | 0.607 | ||
0–1 | 5 (7) | 7 (12) | |
2–4 | 40 (53) | 30 (49) | |
≥ 5 | 30 (40) | 24 (39) |
Imaging data
Sinus rhythm | AF | P value* | |
---|---|---|---|
Echocardiography data | |||
E wave (cm/s) | 75 ± 27 | 92 ± 27 | 0.002 |
E deceleration time (ms) | 259 ± 78 | 211 ± 60 | < 0.001 |
Septal e’ (cm/s) | 6.5 ± 4.6 | 6.6 ± 1.8 | 0.733 |
Lateral e’ (cm/s) | 7.7 ± 2.2 | 8.8. ± 2.6 | 0.104 |
E:e’ ratio | 12.9 ± 4.7 | 12.8 ± 4.7 | 0.858 |
CMR data | |||
LV EDVi (mL/m2) | 71 ± 18 | 75 ± 18 | 0.378 |
LV ESVi (mL/m2) | 23 ± 10 | 28 ± 10 | 0.028 |
LV SVi (mL/m2) | 47 ± 11 | 47 ± 12 | 0.550 |
LV EF (%) | 68 ± 8 | 63 ± 8 | 0.002 |
LVMi (g/m2) | 60 ± 13 | 60 ± 15 | 0.461 |
LVM/EDV (g/mL) | 0.89 ± 0.20 | 0.82 ± 0.17 | 0.503 |
GLS (%) | 14.7 ± 2.4 | 13.6 ± 2.9 | 0.003 |
GCS (%) | 18.3 ± 2.8 | 15.7 ± 3.5 | < 0.001 |
Longitudinal PEDSR (s−1) | 0.53 ± 0.17 | 0.73 ± 0.28 | < 0.001 |
Circumferential PEDSR (s−1) | 0.67 ± 0.23 | 0.86 ± 0.33 | 0.002 |
Maximum LAVi (mL/m2) | 39 ± 15 | 61 ± 30 | < 0.001 |
Minimum LAVi (mL/m2) | 20 ± 11 | 44 ± 27 | < 0.001 |
LAV/LV EDV | 0.56 ± 0.17 | 0.81 ± 0.38 | < 0.001 |
LA EF (%) | 51 ± 12 | 31 ± 15 | < 0.001 |
Presence of LGE, n (%) | 34 (45) | 29 (50) | 0.360 |
Presence of infarct, n (%) | 11 (15) | 11 (18) | 0.382 |
Presence of non-ischaemic LGE, n (%) | 26 (35) | 21 (35) | 0.555 |
Native T1 (ms) | 1237 ± 63 | 1227 ± 84 | 0.879 |
Extracellular Volume (%) | 26.8 ± 4.1 | 28.4 ± 4.9 | 0.092 |
Stress MBF (mL/min/g) | 1.74 ± 0.70 | 1.57 ± 0.63 | 0.424 |
Rest MBF (mL/min/g) | 1.22 ± 0.45 | 0.95 ± 0.32 | 0.042 |
MPR | 1.66 ± 0.72 | 1.72 ± 0.64 | 0.722 |