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Impact of AF on Exercise Capacity in HFpEF

J Am Heart Assoc; ePub 2017 Oct 31; Elshazly, et al

In patients with heart failure with preserved ejection fraction (HFpEF), atrial fibrillation (AF) is associated with peak exercise intolerance, impaired contractile reserve, and increased mortality, but not submaximal exercise capacity, a recent study found. 1,744 patients with HF and ejection fraction and referred for cardiopulmonary stress testing were included in the analysis, 239 of whom had AF. A weighted linear regression model was used to compare metabolic stress parameters and 8-year total mortality between both groups. Researchers found:

  • Weighed mean ejection fraction was 58±5.9% in the entire population.
  • Patients with AF vs those without AF had lower mean peak oxygen consumption, oxygen pulse, and circulatory power, but similar submaximal exercise capacity, after adjusting for unbalanced weighted variables.
  • Both groups had similar peak heart rate, while mean peak systolic blood pressure was lower in the AF group.
  • AF was associated with higher total mortality.


Elshazly MB, Senn T, Wu Y, et al. Impact of atrial fibrillation on exercise capacity and mortality in heart failure with preserved ejection fraction: Insights from cardiopulmonary stress testing. [Published online ahead of print October 31, 2017]. J Am Heart Assoc. doi:10.1161/JAHA.117.006662.