Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation

Grigioni, Francesco; Benfari, Giovanni; Vanoverschelde, Jean–Louis; Tribouilloy, Christophe; Aviérinos, Jean-François; Bursi, Francesca; Pasquet, Agnès; Ruşinaru, Dan; Marcelli, Emanuela; Théron, Alexis; Barbieri, Andréa; Michelena, Héctor I.; Lazam, Siham; Nkomo, Vuyisile T.; Thapa, Prabin; Enríquez-Sarano, Maurice; Suri, Rakesh M.; Clavel, Marie‐Annick; Maalouf, Joseph F.; Trojette, Faouzi; Szymanski, Catherine; Touati, Gilles; Rémadi, Jean-Paul; Guerra, Federico; Capucci, Alessandro; Russo, Antonio; Biagini, Elena; Pasquale, Ferdinando; Ferlito, Marinella; Rapezzi, Claudio; Savini, Carlo; Marinelli, Giuseppe; Pacini, Davide; Gargiulo, Gaetano; Bartolomeo, Roberto Di; Boulif, Jamila; Meester, Christophe de; Khoury, Gébrine El; Gerber, Bernhard; Noirhomme, Philippe; Vancraeynest, David; Collard, F.; Habib, Gilbert; Mantovani, Francesca; Lugli, R.; Modena, Maria Grazia; Boriani, G; Reggiani, Maria Letizia Bacchi

doi:10.1016/j.jacc.2018.10.067

Cited by 62 publications

(43 citation statements)

References 41 publications

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“…The likelihood of developing AF might also be considered in decision-making regarding the appropriate time of valvular intervention in patients with RHD [10,92,93]. Indeed, a recent study in patients with degenerative mitral regurgitation indicated that detection of AF, even paroxysmal, should trigger prompt consideration for surgery [113].…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Noubiap

Nyaga²,

Ndoadoumgue

et al. 2020

Global Heart

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Objective: To estimate the incidence, prevalence, and correlates of atrial fibrillation (AF) in a global population with rheumatic heart disease (RHD). Methods: Bibliographic databases were searched to identify all published studies providing data on AF in patients with RHD. Random-effects meta-analysis method was used to pool estimates. Results: Eighty-three studies were included, reporting data from 75,637 participants with RHD in 42 countries. The global prevalence of AF in RHD was 32.8% (range: 4.3%-79.9%). It was higher in severe valvular disease (30.8% vs 20.7%, p = 0.009), in severe mitral valve disease compared to severe aortic disease (30.4% vs 6.3%, p = 0.038). The global cumulative incidence of AF in patients with RHD was 4.8%, 11.4%, 13.2%, and 30.8% at 1, 2, 5, and 10 years of follow-up, respectively. From comparison between patients with and without AF, AF was associated with increased age (mean difference [MD]: 9.5 years; 95% CI: 7.8-1.3), advanced heart failure (odds ratio [OR]: 4.4; 95% CI 2.1-9.3), tricuspid valve involvement (OR: 4.

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Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Noubiap

Nyaga²,

Ndoadoumgue

et al. 2020

Global Heart

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“…The combination of moderate DMR and PAF had the worst prognostic outcome, even in comparison to the combination of moderate DMR and PeAF. Grigioni et al have reported that the magnitude of the mortality risk progressively increases with the change from PAF to PeAF [24]. Of note, the primary endpoint defined in the present study was a composite of cardiac death and hospital admission due to worsening heart failure.…”

Section: Moderate Dmr and Paf Had The Worst Prognostic Outcomementioning

confidence: 64%

Prognostic significance of moderate primary mitral regurgitation and concomitant paroxysmal atrial fibrillation

Hayashi

Abe

Morita

et al. 2020

Journal of Cardiology

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Mitral regurgitation (MR) is one of the most common valvular heart diseases, and the incidence and prevalence of MR increase continuously with age [1,2]. It is well known that untreated severe MR is associated with poor outcomes, including arrhythmias, hospitalization due to worsening heart failure, and cardiac death because of the adverse consequences of long-standing volume overload on the left ventricle (LV) [3]. The mechanism of MR is classified into two different diseases: primary MR [degenerative MR (DMR)] and secondary MR [functional MR (FMR)]. The natural history of severe DMR has shown poor outcomes [4,5]. Current guidelines recommend early intervention, which can result in excellent outcomes in severe DMR [6,7]. They also recommend periodic monitoring in patients with moderate DMR. However, the evidence to support this practice is limited [8]. Little information is available regarding the characteristics of moderate DMR and their impacts on heart failure. Patients with even moderate DMR can suffer from a worse prognosis [5]. Therefore, the purpose of this retrospective study was to investigate the prognosis and its determinants in patients with moderate DMR. Methods Patients and data collectionWe retroactively evaluated 13,700 patients who underwent transthoracic echocardiography (TTE) in Kitano Hospital, Osaka,

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“…One previous study completed by De Rosa et al found AF negatively affected LV reverse remodeling and 1-year survival after MC treatment in patients with both heart failure and functional mitral regurgitation. [25] Although AF is an established risk factor for adverse cardiovascular events and decreased survival following surgical repair or mitral valve replacement,[ 26 27 ] actually, its impact on MR individuals undertaking MC implantation has not been well studied. With the remarkable increase in MC use, it is crucial to verify the effect of AF on clinical outcomes after MC implantation.…”

Section: Discussionmentioning

confidence: 99%

Impact of atrial fibrillation on outcomes of patients treated by transcatheter mitral valve repair

Sun¹,

Liu²,

Zhang

et al. 2020

Medicine

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Background: Conflicting data have been reported related to the impact of atrial fibrillation (AF) on outcomes after transcatheter mitral valve repair with MitraClip (MC) implantation. In this study, we assessed the prognosis of MC-treated patients according to the presence of pre-existing AF. Methods: Randomized and observational studies reporting outcomes of pre-existing AF or sinus rhythm in patients undergoing MC treatment were identified with an electronic search. Outcomes of interest were short-and long-term mortality, stroke, bleeding, rehospitalization, myocardial infarction (MI), cardiogenic shock, acute procedure success, the hospital stay, and the number of Clips implanted. Results: Eight studies (8466 individuals) were eligible. Compared to sinus rhythm, long-term mortality, the risk of bleeding, rehospitalization, and longer hospital stay were significantly higher in AF groups, whereas similar correlations were found in the analysis of other outcomes. Conclusion: AF may be related with worse outcomes in patients undergoing MC implantation, including long-term mortality, major bleeding, and rehospitalization. AF should be taken into account when referring a patient for MC treatment.

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Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation

Cited by 62 publications

References 41 publications

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Prognostic significance of moderate primary mitral regurgitation and concomitant paroxysmal atrial fibrillation

Impact of atrial fibrillation on outcomes of patients treated by transcatheter mitral valve repair

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