the goal of this case-control cross-sectional study is assessing in a cohort of patients with CHF and permanent AF

• The serum levels of some candidate cytokine variables and their relationship with some selected metabolic variables and some echocardiographic variables.
• the expression degree of some selected miRNA with a pathogenetic relation to atrial fibrillation and the related cardiac remodelling.
• to analyze the correlation between selected miRNA and the selected cytokines.

Inclusion Criteria

• ≥18 years
• Left ventricular ejection fraction >40%
• New York Heart Association class II-IV symptoms
• NT-proBNP ≥600 pg/mL, or ≥900 pg/mL if AF was present on baseline electrocardiography

Exclusion Criteria

- Other AF subtypes (paroxysmal, persistent, long-standing persistent)

At least one of the following criteria:

• Acute heart failure
• NYHA IV
• NT-proBNP >4000 pg/mL
• Significant valvular disease
• Mechanical prosthesis
• Cardiovascular implantable devices
• Active malignancy
• Inflammatory or infectious diseases
• Severe renal (eGFR <30 mL/min/m²) or hepatic failure
• Chronic steroid/anti-inflammatory therapy

consecutive patients with chronic heart failure (CHF) and permanent non-valvular atrial fibrillation (AF), and consecutive patients with CHF, the same risk factors, but sinus rhythm and no prior AF history, admitted to the Internal Medicine and Stroke Care Ward of the "P. Giaccone" Hospital, Palermo

August 2025-August 2030

Professor Tuttolomondo will be responsible for responding to any queries regarding the protocol or results from those who request clarification via his institutional email address.