Figure. Identification of the Left Atrial (LA) Myopathy Phenotype in Atrial Fibrillation (AF) and Heart Failure With Preserved Ejection Fraction (HFpEF).

Atrial fibrillation is commonly associated with mechanical LA dysfunction and, in the presence of dyspnea on exertion, represents an underappreciated form of HFpEF. Patients with AF and dyspnea should be systematically screened for HFpEF using the simple and validated H₂FPEF risk score (eg, at the time of cardioversion). Among patients with persistent dyspnea after restoration of sinus rhythm, the presence of LA myopathy as noted through various investigations identifies a cohort of patients who could benefit from therapies targeting LAmyopathy. Portions of this figure were reproduced with permission from Quail et al⁶ (https://creativecommons.org/licenses/by/4.0/). CMR indicates cardiac magnetic resonance; MR, mitral regurgitation; PCWP, pulmonary capillary wedge pressure.