Gender Differences in Predictors and Long-Term Mortality of New-Onset Postoperative Atrial Fibrillation Following Isolated Aortic Valve Replacement Surgery

Fragão-Marques, Mariana; Mâncio, Jennifer; Oliveira, João; Falcão-Pires, Inês; Leite‐Moreira, Adelino

doi:10.5761/atcs.oa.19-00314

Cited by 12 publications

(10 citation statements)

References 31 publications

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“…Notably, this was observed despite more severe AS based on echocardiographic indices and higher incidence of hypertension recorded in women, both common factors associated with worst prognosis in AS patients [ 53 , 54 ]. Similarly, another study, which included 379 patients with severe AS and with no prior atrial fibrillation, who underwent isolated AVR surgery, reported sex-related differences in factors linked to post-operative atrial fibrillation and its impact on mortality, with an increased risk of death observed in men but not in women [ 55 ]. Moreover, at 4-year follow-up, post-operative atrial fibrillation was associated with the increased risk of death only in men.…”

Section: Sex-related Differences Of Calcific Aortic Valve Stenosismentioning

confidence: 99%

Sex-Specific Features of Calcific Aortic Valve Disease

Summerhill

Moschetta

Orekhov

et al. 2020

IJMS

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Calcific aortic valve disease (CAVD) is the most common valvular heart disease in developed countries predominantly affecting the elderly population therefore posing a large economic burden. It is a gradually progressive condition ranging from mild valve calcification and thickening, without the hemodynamic obstruction, to severe calcification impairing leaflet motion, known as aortic stenosis (AS). The progression of CAVD occurs over many years, and it is extremely variable among individuals. It is also associated with an increased risk of coronary events and mortality. The recent insights into the CAVD pathophysiology included an important role of sex. Accumulating evidence suggests that, in patients with CAVD, sex can determine important differences in the relationship between valvular calcification process, fibrosis, and aortic stenosis hemodynamic severity between men and women. Consequently, it has implications on the development of different valvular phenotypes, left ventricular hypertrophy, and cardiovascular outcomes in men and women. Along these lines, taking into account the sex-related differences in diagnosis, prognosis, and treatment outcomes is of profound importance. In this review, the sex-related differences in patients with CAVD, in terms of pathobiology, clinical phenotypes, and outcomes were discussed.

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Section: Sex-related Differences Of Calcific Aortic Valve Stenosismentioning

confidence: 99%

Sex-Specific Features of Calcific Aortic Valve Disease

Summerhill

Moschetta

Orekhov

et al. 2020

IJMS

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“…It was assessed through telemetry and EKG recordings, as well as doctors’ and nurses’ records, as previously described. 15 Gathered data was introduced in a coded database.…”

Section: Methodsmentioning

confidence: 99%

Adverse remodeling in atrial fibrillation following isolated aortic valve replacement surgery

et al. 2020

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Background: Atrial fibrillation (AF) is the most common arrhythmia with adverse clinical outcomes. Aortic valve replacement (AVR) is one of the most frequently performed cardiac surgeries, although there is scarce evidence on arrhythmic outcomes. We aimed to evaluate AF during the first year post- isolated aortic valve replacement surgery and its clinical, analytical, and echocardiographic predictors. Methods: Severe aortic stenosis patients with no prior atrial fibrillation submitted to isolated aortic valve replacement surgery were included in our study, of which 316 remained in sinus rhythm and 24 developed AF. We performed logistic regression searching for AF predictors and a longitudinal comparison between pre and post-operative echocardiographic data. Results: Postoperative AF (POAF), diabetes, and follow-up indexed Left Atrium Diameter (iLAD) were significantly higher in the group of patients developing AF. POAF and iLAD were independent AF predictors at follow-up. No differences between groups were found regarding baseline and follow-up echocardiographic data except for indexed Left Ventricle End-diastolic Diameter (LVED), which failed to decrease after surgery in the AF group. Conclusions: POAF and iLAD independently predicted AF at 1 year following isolated AVR surgery in aortic stenosis patients with no AF history. iLVED did not decrease significantly at follow-up in AF patients, possibly reflecting adverse ventricular remodeling.

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“…Fragão-Marques et al [32] conducted a study of 379 patients who underwent isolated AVR surgery. They used multiple logistic regression to look at gender-specific predictors of POAF and found an independent association between increased postoperative peak lactate and POAF in men and a lower mean aortic valve gradient with POAF in women (area under the curve (AUC) for the model = 0.77 [0.68-0.86] and 0.69 [0.60-0.78] for men and women, respectively) [32]. At a 4-year followup Fragão-Marques et al [32] found that POAF was linked to increased risk of death in men but not in women.…”

Section: Gendermentioning

confidence: 99%

“…They used multiple logistic regression to look at gender-specific predictors of POAF and found an independent association between increased postoperative peak lactate and POAF in men and a lower mean aortic valve gradient with POAF in women (area under the curve (AUC) for the model = 0.77 [0.68-0.86] and 0.69 [0.60-0.78] for men and women, respectively) [32]. At a 4-year followup Fragão-Marques et al [32] found that POAF was linked to increased risk of death in men but not in women. Conflicting results were obtained by Filardo et al [33] who discovered that the effect of POAF on long-term survival after CABG surgery did not differ between the sexes.…”

Section: Gendermentioning

confidence: 99%

Determinants of atrial fibrillation after cardiac surgery

Qureshi¹,

Ahmed²,

Massie³

et al. 2021

Reviews in Cardiovascular Medicine

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Post-operative Atrial fibrillation (POAF) is a common complication post cardiac surgery. It can result in detrimental short-and long-term outcomes due to the increased risk of stroke, cardiac arrest and congestive heart failure in addition to prolonged intensive care and total hospital stay raising the overall healthcare cost. Accurately identifying predictors and biomarkers for POAF ensures that patients at greatest risk can be given the appropriate prophylactic measures; resources can be distributed to the groups who are most in need and where they will gain the optimum effect. Commonly recurring predictors can be investigated further to unveil the pathophysiology behind POAF, which has yet to be fully understood. This literature review aims to examine relevant studies on the proposed predictors of POAF: increased age, gender, history of atrial fibrillation, hypertension, cardiopulmonary bypass time and the use of beta blockers amongst others. This paper will discuss the significance of both the well-known and newfound risk factors to consolidate the areas that require further exploration in order to highlight those at risk and to unravel the mechanism behind POAF.

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Gender Differences in Predictors and Long-Term Mortality of New-Onset Postoperative Atrial Fibrillation Following Isolated Aortic Valve Replacement Surgery

Cited by 12 publications

References 31 publications

Sex-Specific Features of Calcific Aortic Valve Disease

Sex-Specific Features of Calcific Aortic Valve Disease

Adverse remodeling in atrial fibrillation following isolated aortic valve replacement surgery

Determinants of atrial fibrillation after cardiac surgery

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