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Patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) have increased mortality and increased risk of stroke. Due to the heterogeneous nature of both disease processes, it is difficult to ascertain whether the diagnosis and progression of AF is the cause of deterioration or if it is a symptom of worsening heart failure. This presents physicians with a clinical conundrum of whether optimizing their heart failure will decrease the overall AF burden or if restoration of sinus rhythm is necessary to optimize patients with HFpEF. In this paper, we will review the impact of AF in patients with HFpEF, the pathophysiology and heterogeneity of HFpEF and AF, and the management of these patients. As HFpEF and AF become more prevalent, managing these disease processes needs standardization to improve outcomes. Further research is needed to understand the complex interplay between AF and HFpEF to help determine the best management strategy.
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http://dx.doi.org/10.1016/j.ahjo.2023.100309 | DOI Listing |
JACC Heart Fail
September 2025
Université de Lorraine, Inserm, Centre d'Investigations Cliniques Plurithématique 1433, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France.
Cardiol Rev
September 2025
Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Heart failure (HF) remains one of the leading causes of 30-day hospital readmissions, presenting a major challenge to healthcare systems worldwide. This comprehensive review synthesizes recent evidence on effective strategies to reduce readmission rates through patient education, self-care interventions, and systemic reforms. Structured education-particularly when reinforced postdischarge through methods like teach-back, tele-coaching, and home visits-has consistently demonstrated improved self-management, symptom recognition, and quality of life.
View Article and Find Full Text PDFAnn Am Thorac Soc
September 2025
Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, Massachusetts, United States.
Rationale: There are insufficient data to inform the management of central sleep apnea (CSA) in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Nocturnal oxygen therapy (NOT) has been postulated to benefit CSA patients with HFrEF, but has not been rigorously studied. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.
View Article and Find Full Text PDFAnnu Rev Pathol
September 2025
3Department of Pathology, Stanford University, Stanford, California, USA;
Clonal hematopoiesis, originally identified as a precursor to hematologic malignancies, has emerged as a significant factor in various nonmalignant diseases. Recent research highlights how somatic mutations in hematopoietic stem cells lead to the expansion of circulating mutated immune cells that exert profound effects on organ function and disease progression. These mutated clones display altered inflammatory profiles and tissue-specific functional consequences, contributing to various diseases including atherosclerotic cardiovascular disease, osteoporosis, heart failure, and neurodegenerative conditions.
View Article and Find Full Text PDFEur Heart J Cardiovasc Pharmacother
September 2025
Department of Internal Medicine, University of Genova, Genova, Italy.
Aims: Several diuretic strategies, including furosemide iv boluses (FB) or continuous infusion (FC), are used in acute heart failure (AHF).
Methods And Results: We systematically searched phase 3 randomized clinical trials (RCTs) evaluating diuretic regimens in admitted AHF patients within 48 hours and irrespective of clinical stabilization. We calculated the odds ratio (OR) of FC or FB plus another diuretic (sequential nephron blockade, SNB) compared to FB alone on 24-hour weight loss (WL) and worsening renal function (WRF), with a random-effects model with inverse variance weighting.