Zapata Sofía, Colorado Maria F, Medina Andrés, Mejía Jaime A, Betancur Sofia, Vanegas Johanna M, Díaz James S
School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia.
Clínica Las Américas Auna, Medellín, Colombia.
Clin Cardiol. 2025 Mar;48(3):e70113. doi: 10.1002/clc.70113.
Atrial fibrillation (AF) and heart failure (HF) are highly prevalent conditions associated with significant morbidity and symptom burden.
This study compared the evolution over time of functional class and quality of life (QoL) in patients with HF according to the presence of AF.
A retrospective cohort study was conducted at an outpatient heart failure clinic in Colombia, between 2020 and 2022. Functional class (based on the New York Heart Association classification) and QoL (measured by the Minnesota Living with Heart Failure Questionnaire), were analyzed at baseline, 3 months, 6 months, and the last visit. The simultaneous impact of AF and left ventricular ejection fraction was analyzed using a generalized estimation equation model.
Among the 440 patients (median age 74 years, 56.6% men), 41.4% with AF, and 65.2% with reduced ejection fraction (HFrEF). Over time, functional class improved in both groups, with a more significant improvement in patients without AF. Patients with AF and HFrEF were more likely to remain in worse functional classes (OR: 2.77; 95% CI: 1.37-5.62). Similar trends were observed in QoL questionnaire, with sustained improvement after 3 months. However, AF negatively affected the physical dimension in patients with HFrEF, increasing the QoL questionnaire score by up to 4%.
The presence of AF and reduced ejection fraction was associated with a lesser improvement in functional class and physical dimension of QoL questionnaire, emphasizing the importance of early detection and management of AF as part of comprehensive HF care.
心房颤动（AF）和心力衰竭（HF）是高度常见的疾病，伴有显著的发病率和症状负担。
本研究比较了伴有AF和不伴有AF的HF患者功能分级和生活质量（QoL）随时间的变化情况。
2020年至2022年期间，在哥伦比亚的一家门诊心力衰竭诊所进行了一项回顾性队列研究。在基线、3个月、6个月和最后一次就诊时，分析功能分级（基于纽约心脏协会分类）和QoL（通过明尼苏达心力衰竭生活问卷测量）。使用广义估计方程模型分析AF和左心室射血分数的同时影响。
在440例患者中（中位年龄74岁，男性占56.6%），41.4%患有AF，65.2%射血分数降低（HFrEF）。随着时间的推移，两组的功能分级均有所改善，无AF患者的改善更为显著。患有AF和HFrEF的患者更有可能处于较差的功能分级（OR：2.77；95%CI：1.37 - 5.62）。在QoL问卷中观察到类似趋势，3个月后持续改善。然而，AF对HFrEF患者的身体维度产生负面影响，使QoL问卷得分增加高达4%。
AF的存在和射血分数降低与功能分级和QoL问卷身体维度的改善较小有关，强调了早期检测和管理AF作为综合HF护理一部分的重要性。
