Objective To compare the differences in clinical characteristics between persistent atrial fibrillation(PsAF)combined with heart failure with preserved ejection fraction(HFpEF)and heart failure with reduced ejection fraction(HFrEF),and to clarify the influencing factors and predictive efficacy of PsAF combined with heart failure(HF).Methods A total of 117 inpatients with PsAF admitted to Laiyang Hospital of Traditional Chinese Medicine from February 2023 to February 2025 were selected and divided into PsAF+HFpEF group(n=42),PsAF+HFrEF group(n=34),and PsAF group(n=41)according to the type of HF.The baseline data,serum uric acid(UA)levels and echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left atrium diameter(LAD),right ventricular diameter(RVD),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),stroke volume(SV)and pulmonary artery systolic pressure(PASP)]of three groups of patients were compared.Multivariate Logistic regression analysis was used to identify the independent influencing factors of PsAF combined with HF,and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy.Results The proportions of New York Heart Association(NYHA)cardiac function grade Ⅲ-Ⅳ and hyperuricemia,and heart rate,N-terminal pro-brain natriuretic peptide(NT-proBNP),UA in patients of PsAF+HFpEF group and PsAF+HFrEF group were significantly higher than those in PsAF group(P＜0.05).The serum creatinine level of patients in PsAF+HFrEF group was significantly higher than that in PsAF+HFpEF group and PsAF group(P＜0.05).The levels of LVESD,LVEDD,LAD,RVD,PASP,LVEDV and LVESV in PsAF+HFrEF group were significantly higher than those in PsAF group(P＜0.05).The LVESD,LVEDD,LAD,LVEDV and LVESV of patients in PsAF+HFpEF group were significantly lower than those in PsAF+HFrEF group(P＜0.05),LAD and PASP were significantly higher than those in PsAF group(P＜0.05).There was a statistically significant difference in LVEF among three groups of patients(P＜0.05),in sequence:PsAF group＞PsAF+HFpEF group＞PsAF+HFrEF group.Multivariate Logistic regression analysis showed that NT-proBNP,UA,and NYHA cardiac function grade Ⅲ-Ⅳ were all independent risk factors for PsAF complicated with HF,and LVEF was an independent protective factor(P＜0.05).The area under the curve for combined prediction of PsAF combined with HF by NT-proBNP+UA+LVEF was 0.967.Conclusion NT-proBNP,UA and LVEF are all independent predictors of PsAF complicated with HF.The combination of three has highly efficient predictive value and provides an efficient tool for clinical risk stratification.

Objective To compare the differences in clinical characteristics between persistent atrial fibrillation(PsAF)combined with heart failure with preserved ejection fraction(HFpEF)and heart failure with reduced ejection fraction(HFrEF),and to clarify the influencing factors and predictive efficacy of PsAF combined with heart failure(HF).Methods A total of 117 inpatients with PsAF admitted to Laiyang Hospital of Traditional Chinese Medicine from February 2023 to February 2025 were selected and divided into PsAF+HFpEF group(n=42),PsAF+HFrEF group(n=34),and PsAF group(n=41)according to the type of HF.The baseline data,serum uric acid(UA)levels and echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left atrium diameter(LAD),right ventricular diameter(RVD),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),stroke volume(SV)and pulmonary artery systolic pressure(PASP)]of three groups of patients were compared.Multivariate Logistic regression analysis was used to identify the independent influencing factors of PsAF combined with HF,and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy.Results The proportions of New York Heart Association(NYHA)cardiac function grade Ⅲ-Ⅳ and hyperuricemia,and heart rate,N-terminal pro-brain natriuretic peptide(NT-proBNP),UA in patients of PsAF+HFpEF group and PsAF+HFrEF group were significantly higher than those in PsAF group(P＜0.05).The serum creatinine level of patients in PsAF+HFrEF group was significantly higher than that in PsAF+HFpEF group and PsAF group(P＜0.05).The levels of LVESD,LVEDD,LAD,RVD,PASP,LVEDV and LVESV in PsAF+HFrEF group were significantly higher than those in PsAF group(P＜0.05).The LVESD,LVEDD,LAD,LVEDV and LVESV of patients in PsAF+HFpEF group were significantly lower than those in PsAF+HFrEF group(P＜0.05),LAD and PASP were significantly higher than those in PsAF group(P＜0.05).There was a statistically significant difference in LVEF among three groups of patients(P＜0.05),in sequence:PsAF group＞PsAF+HFpEF group＞PsAF+HFrEF group.Multivariate Logistic regression analysis showed that NT-proBNP,UA,and NYHA cardiac function grade Ⅲ-Ⅳ were all independent risk factors for PsAF complicated with HF,and LVEF was an independent protective factor(P＜0.05).The area under the curve for combined prediction of PsAF combined with HF by NT-proBNP+UA+LVEF was 0.967.Conclusion NT-proBNP,UA and LVEF are all independent predictors of PsAF complicated with HF.The combination of three has highly efficient predictive value and provides an efficient tool for clinical risk stratification.