J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 16, Number 11, November 2024, pages 547-553

Possible Risk Factors Contributing to Atrial Fibrillation Occurrence in Heart Failure With Mildly Reduced Ejection Fraction

↓ **Table 1.** Baseline Demographics and Clinical Characteristics in all Observed HFmrEF Patient With and Without AF
Indices, units	HFmrEF/no AF (n = 76)	HFmrEF/paroxysmal AF (n = 103)	HFmrEF/persistent AF (n = 90)
Data represented as mean (range). *P < 0.05. AF: atrial fibrillation; BMI: body mass index; DBP: diastolic blood pressure; HR: heart rate; IHD: ischemic heart disease; HFmrEF: heart failure with mildly reduced ejection fraction; SBP: systolic blood pressure; bpm: beats per minute.
Age (years)	56 (49 - 74)	54 (47 - 71)	56 (51 - 73)
Male (%)	53.2	50.8	52.4
BMI (kg/m²)	29.8 (27 - 32)	30.1 (27 - 34)	31.1 (28 - 36)
History of smoking (%)	42.2	44.6	41.7
History of drinking (%)	11.9	14.7	12.6
IHD (%)	74.7	72.7	73.3
Hypertension (%)	87.4	88.7	89.1
Hypercholesterolemia (%)	47.9	48.9	46.8
Resting heart rate (bpm)	75.2 (68 - 89)	76.7 (72 - 91)	74.3 (65 - 90)
Peak heart rate (bpm)	116.8 (92 - 131)	121.7 (92 - 133)*	115.8 (96 - 123)
Resting SBP (mm Hg)	141.9 (125 - 155)	144.9 (131 - 160)	145.9 (131 - 150)
Peak SBP (mm Hg)	164.1 (145 - 180)	168.8 (140 - 185)	167.1 (40 - 180)
Resting DBP (mm Hg)	83.7 (75 - 95)	78.1 (70 - 90)	84.7 (75 - 95)
Peak DBP (mm Hg)	91.2 (80 - 110)	95.2 (80 - 105)*	92.1 (80 - 110)

↓ Table 1. Baseline Demographics and Clinical Characteristics in all Observed HFmrEF Patient With and Without AF

Indices, units

HFmrEF/no AF (n = 76)

HFmrEF/paroxysmal AF (n = 103)

HFmrEF/persistent AF (n = 90)

Data represented as mean (range). *P < 0.05. AF: atrial fibrillation; BMI: body mass index; DBP: diastolic blood pressure; HR: heart rate; IHD: ischemic heart disease; HFmrEF: heart failure with mildly reduced ejection fraction; SBP: systolic blood pressure; bpm: beats per minute.

Age (years)

56 (49 - 74)

54 (47 - 71)

56 (51 - 73)

Male (%)

53.2

50.8

52.4

BMI (kg/m²)

29.8 (27 - 32)

30.1 (27 - 34)

31.1 (28 - 36)

History of smoking (%)

42.2

44.6

41.7

History of drinking (%)

11.9

14.7

12.6

IHD (%)

74.7

72.7

73.3

Hypertension (%)

87.4

88.7

89.1

Hypercholesterolemia (%)

47.9

48.9

46.8

Resting heart rate (bpm)

75.2 (68 - 89)

76.7 (72 - 91)

74.3 (65 - 90)

Peak heart rate (bpm)

116.8 (92 - 131)

121.7 (92 - 133)*

115.8 (96 - 123)

Resting SBP (mm Hg)

141.9 (125 - 155)

144.9 (131 - 160)

145.9 (131 - 150)

Peak SBP (mm Hg)

164.1 (145 - 180)

168.8 (140 - 185)

167.1 (40 - 180)

Resting DBP (mm Hg)

83.7 (75 - 95)

78.1 (70 - 90)

84.7 (75 - 95)

Peak DBP (mm Hg)

91.2 (80 - 110)

95.2 (80 - 105)*

92.1 (80 - 110)

↓ **Table 2.** The Analysis of OR Values at a 95% CI of Various Clinical Hemodynamic and Structural-Functional Parameters and Markers of Inflammation and Fibrosis in HFmrEF Patients With Paroxysmal AF Compared to the Control Group
Indices	HFmrEF with paroxysmal AF (n = 103)
*P ≤ 0.05. AF: atrial fibrillation; A peak: late diastolic filling wave; BMI: body mass index; DBP: diastolic blood pressure; DT: deceleration time; E peak: early diastolic filling wave; E/A ratio: the ratio of the E peak to the A peak; EF: ejection fraction; HFmrEF: heart failure with mildly reduced ejection fraction; HCs: hypertensive crises; HR: heart rate; hs-СRP: high-sensitivity C-reactive protein; IHD: ischemic heart disease; IL-6: interlekine-6; IVRT: isovolumetric relaxation time; IVST: interventricular septum thickness; LAD: left atrial diameter; LAV: left atrial volume; LVEDD: left ventricle end-diastolic diameter; LVEDV: left ventricle end-diastolic volume; LVESD: left ventricle end-systolic diameter; LVESV: left ventricle end-systolic volume; LVPWT: left ventricle posterior wall thickness; MI: myocardial infarction; Pdis: P-wave dispersion; Pmax: P-wave maximum; SBP: systolic blood pressure; TIA: transitory ischemic attacks; TNF-α: tumor necrosis factor-α; ТGF-β1: transforming growth factor-β1; OR: odds ratio; CI: confidence interval.
Sex	0.24	0.10 - 0.58	0.07
Age	1.18	1.08 - 1.28	0.05*
SBP	1.00	0.94 - 1.05	0.987
DBP	1.09	1.01 - 1.17	0.017*
HR	1.03	0.98 - 1.08	0.182
HC	1.17	1.07 - 1.43	0.01*
TIA	0.65	0.14 - 2.93	0.583
IHD	1.16	0.39 - 3.42	0.788
MI	1.6	0.65 - 4.33	0.285
Pmax	3.92	3.88 - 3.96	0.002*
Pdis	3.91	3.87 - 3.95	0.002*
QRS	0.10	0.96 - 1.04	0.989
BMI	1.13	0.93 - 1.27	0.031*
LAD	0.86	0.70 - 1.06	0.167
LAV	1.76	1.66 - 1.88	0.002*
LVEDD	0.92	0.71 - 1.20	0.558
LVEDV	0.99	0.94 - 1.04	0.811
LVESD	0.98	0.89 - 1.08	0.770
IVST	0.94	0.68 - 1.31	0.751
LVPWT	0.96	0.64 - 1.45	0.877
EF	1.11	0.94 - 1.30	0.188
Е peak	1.00	0.96 - 1.03	0.959
А peak	1.00	0.93 - 1.08	0.927
Е/А	1.05	0.04 - 2.32	0.975
DT	0.99	0.97 - 1.02	0.777
IVRT	0.99	0.95 - 1.03	0.661
hs-СRP	5.57	3.38 - 7.87	0.010*
IL-6	4.80	2.72 - 6.88	0.001*
TNF-α	2.56	1.43 - 4.73	0.002*
ТGF-β1	0.57	0.00 - 4.2	0.995

↓ Table 2. The Analysis of OR Values at a 95% CI of Various Clinical Hemodynamic and Structural-Functional Parameters and Markers of Inflammation and Fibrosis in HFmrEF Patients With Paroxysmal AF Compared to the Control Group

Indices

HFmrEF with paroxysmal AF (n = 103)

95% CI

P value

*P ≤ 0.05. AF: atrial fibrillation; A peak: late diastolic filling wave; BMI: body mass index; DBP: diastolic blood pressure; DT: deceleration time; E peak: early diastolic filling wave; E/A ratio: the ratio of the E peak to the A peak; EF: ejection fraction; HFmrEF: heart failure with mildly reduced ejection fraction; HCs: hypertensive crises; HR: heart rate; hs-СRP: high-sensitivity C-reactive protein; IHD: ischemic heart disease; IL-6: interlekine-6; IVRT: isovolumetric relaxation time; IVST: interventricular septum thickness; LAD: left atrial diameter; LAV: left atrial volume; LVEDD: left ventricle end-diastolic diameter; LVEDV: left ventricle end-diastolic volume; LVESD: left ventricle end-systolic diameter; LVESV: left ventricle end-systolic volume; LVPWT: left ventricle posterior wall thickness; MI: myocardial infarction; Pdis: P-wave dispersion; Pmax: P-wave maximum; SBP: systolic blood pressure; TIA: transitory ischemic attacks; TNF-α: tumor necrosis factor-α; ТGF-β1: transforming growth factor-β1; OR: odds ratio; CI: confidence interval.

Sex

0.24

0.10 - 0.58

0.07

Age

1.18

1.08 - 1.28

0.05*

SBP

1.00

0.94 - 1.05

0.987

DBP

1.09

1.01 - 1.17

0.017*

1.03

0.98 - 1.08

0.182

1.17

1.07 - 1.43

0.01*

TIA

0.65

0.14 - 2.93

0.583

IHD

1.16

0.39 - 3.42

0.788

1.6

0.65 - 4.33

0.285

Pmax

3.92

3.88 - 3.96

0.002*

Pdis

3.91

3.87 - 3.95

0.002*

QRS

0.10

0.96 - 1.04

0.989

BMI

1.13

0.93 - 1.27

0.031*

LAD

0.86

0.70 - 1.06

0.167

LAV

1.76

1.66 - 1.88

0.002*

LVEDD

0.92

0.71 - 1.20

0.558

LVEDV

0.99

0.94 - 1.04

0.811

LVESD

0.98

0.89 - 1.08

0.770

IVST

0.94

0.68 - 1.31

0.751

LVPWT

0.96

0.64 - 1.45

0.877

1.11

0.94 - 1.30

0.188

Е peak

1.00

0.96 - 1.03

0.959

А peak

1.00

0.93 - 1.08

0.927

Е/А

1.05

0.04 - 2.32

0.975

0.99

0.97 - 1.02

0.777

IVRT

0.99

0.95 - 1.03

0.661

hs-СRP

5.57

3.38 - 7.87

0.010*

IL-6

4.80

2.72 - 6.88

0.001*

TNF-α

2.56

1.43 - 4.73

0.002*

ТGF-β1

0.57

0.00 - 4.2

0.995

↓ **Table 3.** The Analysis OR Value of Various Clinical Hemodynamic and Structural-Functional Parameters, as Well as Markers of Inflammation and Fibrosis in HFmrEF Patients With Persistent AF Compared With the Control Group
Indices	HFmrEF with persistent AF (n = 90)
*P ≤ 0.05. AF: atrial fibrillation; A peak: late diastolic filling wave; BMI: body mass index; DBP: diastolic blood pressure; DT: deceleration time; E peak: early diastolic filling wave; E/A ratio: the ratio of the E peak to the A peak; EF: ejection fraction; HFmrEF: heart failure with mildly reduced ejection fraction; HCs: hypertensive crises; HR: heart rate; hs-СRP: high-sensitivity C-reactive protein; IHD: ischemic heart disease; IL-6: interlekine-6; IVRT: isovolumetric relaxation time; IVST: interventricular septum thickness; LAD: left atrial diameter; LAV: left atrial volume; LVEDD: left ventricle end-diastolic diameter; LVEDV: left ventricle end-diastolic volume; LVESD: left ventricle end-systolic diameter; LVESV: left ventricle end-systolic volume; LVPWT: left ventricle posterior wall thickness; MI: myocardial infarction; Pdis: P-wave dispersion; Pmax: P-wave maximum; SBP: systolic blood pressure; TIA: transitory ischemic attacks; TNF-α: tumor necrosis factor-α; ТGF-β1: transforming growth factor-β1; OR: odds ratio; CI: confidence interval.
Sex	0.30	0.12 - 0.74	0.09
Age	1.06	0.98 - 1.14	0.101
SBP	0.98	0.94 - 1.04	0.661
DBP	1.00	0.94 - 1.07	0.801
HR	0.96	0.92 - 1.01	0.142
HC	1.56	1.04 - 1.97	0.001*
TIA	0.69	0.14 - 2.93	0.583
ICD	1.32	0.45 - 3.83	0.608
MI	2.20	0.81 - 5.95	0.120
Pmax	4.81	4.07 - 5.94	0.001*
Pdis	4.90	4.86 - 5.93	0.001*
QRS	0.97	0.93 - 1.01	0.168
BMI	1.97	0.98 - 2.21	0.044*
LAD	3.80	2.65 - 4.09	0.040*
LAV	3.69	2.58 - 4.82	0.002*
LVEDD	1.76	1.58 - 1.99	0.046*
LVEDV	1.93	1.89 - 2.09	0.019*
LVESV	0.96	0.88 - 1.06	0.480
IVST	1.69	1.48 - 1.98	0.042*
LVPWT	0.83	0.55 - 1.24	0.368
EF	1.30	1.08 - 1.57	0.05*
Е peak	3.05	3.01 - 3.09	0.012*
А peak	0.93	0.86 - 1.00	0.059
Е/А	1.05	1.02 - 2.55	0.720
DT	0.97	0.95 - 1.00	0.071
IVRT	3.94	3.90 - 4.99	0.016*
Hs-CRP	6.37	5.24 - 8.59	0.002*
IL-6	5.78	4.71 - 7.87	0.001*
TNF-α	2.51	2.37 - 4.68	0.002*
ТGF-β1	3.84	2.10 - 6.23	0.005*

↓ Table 3. The Analysis OR Value of Various Clinical Hemodynamic and Structural-Functional Parameters, as Well as Markers of Inflammation and Fibrosis in HFmrEF Patients With Persistent AF Compared With the Control Group

Indices

HFmrEF with persistent AF (n = 90)

ОR

95% CI

P values

Sex

0.30

0.12 - 0.74

0.09

Age

1.06

0.98 - 1.14

0.101

SBP

0.98

0.94 - 1.04

0.661

DBP

1.00

0.94 - 1.07

0.801

0.96

0.92 - 1.01

0.142

1.56

1.04 - 1.97

0.001*

TIA

0.69

0.14 - 2.93

0.583

ICD

1.32

0.45 - 3.83

0.608

2.20

0.81 - 5.95

0.120

Pmax

4.81

4.07 - 5.94

0.001*

Pdis

4.90

4.86 - 5.93

0.001*

QRS

0.97

0.93 - 1.01

0.168

BMI

1.97

0.98 - 2.21

0.044*

LAD

3.80

2.65 - 4.09

0.040*

LAV

3.69

2.58 - 4.82

0.002*

LVEDD

1.76

1.58 - 1.99

0.046*

LVEDV

1.93

1.89 - 2.09

0.019*

LVESV

0.96

0.88 - 1.06

0.480

IVST

1.69

1.48 - 1.98

0.042*

LVPWT

0.83

0.55 - 1.24

0.368

1.30

1.08 - 1.57

0.05*

Е peak

3.05

3.01 - 3.09

0.012*

А peak

0.93

0.86 - 1.00

0.059

Е/А

1.05

1.02 - 2.55

0.720

0.97

0.95 - 1.00

0.071

IVRT

3.94

3.90 - 4.99

0.016*

Hs-CRP

6.37

5.24 - 8.59

0.002*

IL-6

5.78

4.71 - 7.87

0.001*

TNF-α

2.51

2.37 - 4.68

0.002*

ТGF-β1

3.84

2.10 - 6.23

0.005*