Clinical, Echocardiographic, and Hemodynamic Characteristics of Rheumatic Mitral Valve Stenosis and Atrial Fibrillation

Kabukçu, Mehmet; Arslantaş, Esin; Ateş, İsmail; Demircioğlu, Fatih; Ersel, Filiz

doi:10.1177/000331970505600206

Cited by 24 publications

(23 citation statements)

References 17 publications

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“…Clinical, echocardiographic and laboratory findings in Table 1 were evaluated and univariable predictors of AF were determined. We employed an epidemiological approach and factors that have been shown to be multivariable predictors of AF in the previous studies [1,[12][13][14] or P \ 0.15 with univariable analysis in Table 1 have been accepted as potential predictors. Therefore, smoking, age, functional capacity, mitral valve area, ejection fraction, left atrial diameter, and NT-proBNP, HsCRP and CA-125 levels have been entered into a multivariable logistic regression analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation and elevated left ventricular enddiastolic pressure has been shown to be associated with AF [2][3][4][5][6][7][8][9][10]. In the previous studies, several clinical, echocardiographic parameters as well as high-sensitivity C-reactive protein (HsCRP), as a marker of inflammation, have been shown to be associated with development of AF in patients with rheumatic MS [1,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with the development of atrial fibrillation in patients with rheumatic mitral stenosis

Özaydın

Türker

Varol

et al. 2010

Int J Cardiovasc Imaging

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The aim of this study was to evaluate the factors associated with the development of atrial fibrillation (AF) in patients with rheumatic mitral stenosis (MS). A total of 146 consecutive patients with rheumatic MS were screened. They were accepted to be in AF group and sinus rhythm group according to their rhythm in the baseline ECG. After screening, 38 patients were excluded due to hyperthyroidism (n = 13), chronic obstructive pulmonary disease (n = 22), malignancy (n = 2) and rheumatoid arthritis (n = 1). Therefore, remaining 108 patients, 74 of whom in sinus rhythm (MS-SR) and 34 of whom in AF (MS-AF) constituted study population. Fourty age- and gender-matched patients constituted control group. Factors associated with development of AF in multivariable analysis included High sensitivity C reactive protein (P = 0.005; odds ratio, 3.44; 95% confidence interval, 1.44-8.22), N-terminal of brain natriuretic peptide precursor (P < 0.0001; odds ratio, 1.03; 95% confidence interval, 1.02-1.06) and left atrial diameter (P < 0.0001; odds ratio, 1.68; 95% confidence interval, 1.32-2.14). Present study suggests that High sensitivity C reactive protein, N-terminal of brain natriuretic peptide precursor and left atrial diameter are associated with development AF in patients with MS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with the development of atrial fibrillation in patients with rheumatic mitral stenosis

Özaydın

Türker

Varol

et al. 2010

Int J Cardiovasc Imaging

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“…The hemodynamic overload and AF itself contribute to the structural remodeling that leads to an increase in left atrial size resulting in increasing the atrial surface area available for the wandering wavelets [8]. Furthermore, sympathetic activity is increased in the patients with mitral stenosis, probably due to altered arterial baroreflex sensitivity [10]. Chronically raised left atrial pressure causes increased wall stress and hence perpetual cavity dilatation which is then associated with different degrees of midwall fibrosis.…”

Section: Mechanism Of Af and Electrical Remodeling In Rhdmentioning

confidence: 99%

Light and electron microscopic features of surgically excised left atrial appendage in rheumatic heart disease patients with atrial fibrillation and sinus rhythm

Sharma

Hote

et al. 2014

Cardiovascular Pathology

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“…Chronic AF is associated with an increased risk of embolic events and negative impact on cardiac function and, therefore, an increased morbidity and mortality risk in patients with rheumatic MS (16). Therefore, the identification of patients who are susceptible to the development of AF will be of great value.…”

Section: Discussionmentioning

confidence: 99%

P-wave dispersion in patients with rheumatic mitral stenosis

Rezaian¹,

Rezaian²,

Liaghat³

et al. 2007

Int J Angiol

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It has previously been shown that maximum P-wave duration and P-wave dispersion in 12-lead surface electrocardiogram (ECG) are significantly increased in patients prone to developing atrial fibrillation. Because patients with mitral stenosis (MS) are also susceptible to developing atrial fibrillation, the present study was carried out to determine whether maximum P-wave duration and P-wave dispersion are prolonged in MS patients during normal sinus rhythm. In addition, the correlation between these P-wave variables and the left atrial size, transmitral valve gradient and mitral valve area were determined. Fifty consecutive patients (40 women and 10 men; mean age 35.76±6.59 years) with MS who were in normal sinus rhythm, and a control group of 50 age-and sex-matched healthy persons were studied. A 12-lead ECG was obtained for each subject. All ECGs were scanned through a Cannon scanner at 300 dpi and saved as images in a personal computer. The minimum and maximum P-wave durations, as well as P-wave dispersion, were subsequently calculated. In addition, all patients were evaluated by echocardiography to measure the left atrial size, transmitral valve gradient and mitral valve area by planimetry. The P-wave parameters were compared between the two groups and the correlation between these parameters and the echocardiographic variables were determined in patients with MS. The most important findings included a significant prolongation of maximum P-wave duration in patients with MS compared with controls (P<0.001), and a strong correlation between the maximum P-wave duration and left atrial size (r=0.505, P<0.001), transmitral valve gradient (r=0.371, P=0.01) and a significant negative correlation with mitral valve area (r=-0.379, P=0.007). There was no correlation between the P-wave dispersion and echocardiographic parameters.Key Words: Maximum P-wave duration; Minimum P-wave duration; P-wave dispersion; Rheumatic mitral stenosis P -wave prolongation has been used as a marker of interatrial conduction disturbance and prolonged atrial conduction time, which has been associated with a high frequency of atrial fibrillation (AF). These atrial conduction disturbances are nonuniform and site dependent, and may result in a highly variable P-wave duration in the different leads of a 12-lead electrocardiogram (ECG). As a marker of this variation, the Pwave dispersion has been introduced as the difference between the maximum and minimum P-wave duration. Prolonged Pwave duration and P-wave dispersion have been found to be predictive of later AF in patients with idiopathic AF (1-4), and recurrence of AF following cardioversion (5,6).Because patients with rheumatic mitral stenosis (MS) are prone to develop AF, the present study was designed to find out whether the maximum P-wave duration and P-wave dispersion are prolonged in these patients, and to find out if these variables have any correlation with the left atrial size, transmitral valve gradient or mitral valve area as an index of the severity of valvular stenosis. METHODS Pa...

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Clinical, Echocardiographic, and Hemodynamic Characteristics of Rheumatic Mitral Valve Stenosis and Atrial Fibrillation

Cited by 24 publications

References 17 publications

Factors associated with the development of atrial fibrillation in patients with rheumatic mitral stenosis

Factors associated with the development of atrial fibrillation in patients with rheumatic mitral stenosis

Light and electron microscopic features of surgically excised left atrial appendage in rheumatic heart disease patients with atrial fibrillation and sinus rhythm

P-wave dispersion in patients with rheumatic mitral stenosis

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