THE INFLUENCE OF HYPERTENSION ON HEART FAILURE'S PHENOTYPES IN PATIENTS WITH HEART FAILURE AND ATRIAL FIBRILLATION, IN COMPARISON TO PATIENTS WITH HEART FAILURE AND SINUS RHYTHM

Abstract

Objective: Atrial fibrillation is being characterised as both an etiological factor and a consequence for developing heart failure, while it does the same for the latter. Our aim was to identify whether and in which way, the presence of hypertension influences the development of the three phenotypes of heart failure in patients with heart failure and atrial fibrillation, as well as in patients with heart failure alone. Design and method: We analysed 194 patients: 97 with heart failure and atrial fibrillation (group A) and 97 patients with heart failure in sinus rhythm (group B), randomly selected from 2019 to 2021. The phenotypes of heart failure were selected according to 2021 European Society of Cardiology Guidelines: patients with heart failure with reduced ejection fraction (1), with mildly reduced ejection fraction (2) and with preserved ejection fraction (3). Results: In patients belonging to A1 group (n = 44) the result was that hypertension has not played a significant role in developing this phenotype (p = 0.1347), in comparison to patients in B1 group (n = 30), where the association between hypertension and heart failure with reduced ejection fraction was statistically significant (p = 0.0263). What is more, patients in A2 group (n = 14), as well as those in B2 group (n = 24), were not associated with the presence of hypertension (p = 0.4686, respectively p = 0.5638). As well as the latter, hypertension did not influence the development of heart failure with preserved ejection fraction in both groups. Conclusions: Taking into consideration that hypertension illustrates a common aetiology for both pathologies mentioned above, we discovered that hypertension's presence influenced more the heart failure in sinus rhythm group, concluding that atrial fibrillation associated with heart failure did not pose an additive risk factor for hypertension developing. In addition, regarding the phenotypes, it was heart failure with a reduced ejection fraction that was influenced by hypertension. Further researches will improve the comprehensive relationship between hypertension, atrial fibrillation and heart failure, leading towards better management strategies.