Background: Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia in clinical practice. Heart failure (HF) can occur concurrently with AF. Aim: We compared different demographic, clinical, and echocardiographic characteristics between patients with AF+HF and patients with AF only. Furthermore, we explored whether concurrent HF independently predicts several outcomes (all-cause mortality, cardiovascular mortality, ischemic stroke/systemic embolism (IS/SE), major bleeding, and clinically relevant non-major bleeding (CRNMB)). Materials and Methods: Comparisons between the AF+HF and the AF-only group were carried out. Multivariable Cox proportional hazard models were constructed for each outcome to assess whether HF was predictive of any of them while controlling for possible confounding factors. Results: A total of 2020 patients were included in this study: 481 had AF+HF; 1539 had AF only. AF+HF patients were older, more commonly males, and had a higher prevalence of diabetes mellitus, dyslipidemia, coronary artery disease, and chronic kidney disease (p≤0.05). Furthermore, AF+HF patients more commonly had pulmonary hypertension and low ejection fraction (p≤0.001). Finally, HF was independently predictive of all-cause mortality (adjusted HR 2.17, 95% CI (1.66-2.85) and cardiovascular mortality (adjusted HR 2.37, 95% CI (1.68-3.36). Conclusion: Coexisting AF+HF was associated with a more labile and higher-risk population among Jordanian patients. Furthermore, coexisting HF independently predicted higher all-cause mortality and cardiovascular mortality. Efforts should be made to efficiently identify such cases early and treat them aggressively.

中文翻译：

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心房颤动患者共存心力衰竭的临床、超声心动图和治疗特征以及预后结果的评估：约旦心房颤动 (JoFib) 研究

背景：心房颤动（AF）是临床实践中最常见的心律失常。心力衰竭 (HF) 可与 AF 同时发生。目的：我们比较了 AF+HF 患者和仅 AF 患者之间不同的人口统计学、临床和超声心动图特征。此外，我们还探讨了并发心力衰竭是否可以独立预测多种结局（全因死亡率、心血管死亡率、缺血性卒中/全身性栓塞（IS/SE）、大出血和临床相关非大出血（CRNMB））。材料和方法：对 AF+HF 组和仅 AF 组进行比较。针对每个结果构建了多变量 Cox 比例风险模型，以评估 HF 是否可以预测其中任何一个结果，同时控制可能的混杂因素。结果：本研究共纳入2020例患者：481例为AF+HF；481例为AF+HF；1539只有AF。AF+HF 患者年龄较大，男性更常见，糖尿病、血脂异常、冠状动脉疾病和慢性肾脏病的患病率较高（p≤0.05）。此外，AF+HF 患者更常见肺动脉高压和低射血分数（p≤0.001）。最后，心力衰竭可独立预测全因死亡率（调整后的 HR 2.17，95% CI (1.66-2.85) 和心血管死亡率（调整后的 HR 2.37，95% CI (1.68-3.36)）。结论：共存 AF+HF 与约旦患者是一个更加不稳定和高危的人群。此外，合并心力衰竭独立预测更高的全因死亡率和心血管死亡率。应努力早期有效识别此类病例并积极治疗。