Is atrial fibrillation a mechanism or a bystander in heart failure ?
AF and heart failure with a preserved ejection fraction (HFpEF) are vicious twins. Patients with AF and HFpEF are heterogeneous and share clinical risk factors, like hypertension, diabetes and obesity. These factors are linked, both to each other and to adverse cardiovascular outcomes. AF is an independent prognostic factor in patients with HFpEF. It is questioned whether it is AF itself that contributes to worse prognosis, or, instead, whether AF is just a bystander being a marker of more severe atrial and ventricular diseases. Extensive phenotyping to assess the presence of risk factors using (new) imaging techniques, measures of atrial myopathy, and of diastolic dysfunction, are essential.
The central hypothesis of our study project links AF (progression) with HFpEF (progression), and risk factors.
WP 1: Pathophysiology and prognostic significance of AF depends on severity of risk factors (clinical study)
WP 2: Atrial myopathy develops in association with and as marker of ventricular myopathy (experimental lab)
WP 3: Diabetes, hypertension and obesity play a pivotal role as risk factors for atrial and ventricular myopathy (clinical study and experimental lab)
WP 4: Personalized risk factor reduction reduces AF progression, atrial myopathy and severity of HFpEF (clinical study)
Medical degree; experience with experimental work
Prof. Isabelle C. van Gelder, MD PhD, Cardiology, University Medical Center Groningen
Michiel Rienstra, MD PhD, Cardiology, University Medical Center Groningen
Prof. Rudolf A. de Boer, MD PhD, Cardiology, University Medical Center Groningen
Prof. Adriaan A. Voors, MD PhD, Cardiology, University Medical Center Groningen