Prevalence, clinical characteristics, and outcome of atrial functional mitral regurgitation in hospitalized heart failure patients with atrial fibrillation

Saito, Chihiro; Minami, Yuichiro; Arai, Kotaro; Haruki, Shintaro; Yagishita, Yoshimi; Jujo, Kentaro; Ashihara, Kaoru; Hagiwara, Nobuhisa

doi:10.1016/j.jjcc.2018.04.002

Cited by 33 publications

(30 citation statements)

References 41 publications

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“…Functional tricuspid regurgitation occurred in 15% of patients; in 3.7%, tricuspid regurgitation coexisted with AFMR. 22 Moderate or greater secondary Carpentier type I MR was observed in 6.5% of all patients undergoing a first catheter ablation for AF in a retrospective study. 3 In hospitalized heart failure (HF) with preserved EF in patients with AF, the prevalence of moderate or severe AFMR was 15.9%.…”

Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 94%

“…With respect to sex, history of hypertension, diabetes, or prior coronary revascularization, there appeared to be no differences between AFMR patients and AF patients without MR. Interestingly, AFMR patients had lower hemoglobin and higher uric acid levels, and less frequent use of beta-blockers than ventricular FMR patients. 22 Prognostically, the all-cause mortality and HF rehospitalization rate of AFMR over a median period of 273 days were 13.3% and 36.7%, respectively. 22 AFMR patients had a significantly higher risk of readmission for HF than those with HF and reduced EF but without MR, and a higher rate of a composite of cardiac death and readmission for HF compared to HF patients without MR, irrespective of LVEF.…”

Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 96%

“…3 In hospitalized heart failure (HF) with preserved EF in patients with AF, the prevalence of moderate or severe AFMR was 15.9%. 22 Compared to patients without MR, AFMR patients were older and more often had persistent AF. 3,22 Consistently reported in multiple studies, LA size is significantly larger in AFMR patients than in those with AF but no MR. 3,21,22 They appeared to be less likely to have dyslipidemia than ventricular FMR patients.…”

Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 99%

“…22 Compared to patients without MR, AFMR patients were older and more often had persistent AF. 3,22 Consistently reported in multiple studies, LA size is significantly larger in AFMR patients than in those with AF but no MR. 3,21,22 They appeared to be less likely to have dyslipidemia than ventricular FMR patients. With respect to sex, history of hypertension, diabetes, or prior coronary revascularization, there appeared to be no differences between AFMR patients and AF patients without MR. Interestingly, AFMR patients had lower hemoglobin and higher uric acid levels, and less frequent use of beta-blockers than ventricular FMR patients.…”

Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 99%

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Atrial functional mitral regurgitation: mechanisms and surgical implications

Fan

Wan

Wong

et al. 2020

Asian Cardiovasc Thorac Ann

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The term atrial functional mitral regurgitation refers to a newly recognized disease entity in which mitral regurgitation occurs secondary to left atrial disease, without left ventricular dilatation and intrinsic mitral valve disease, typically in the setting of long-standing atrial fibrillation. Recent evidence suggests that atrial functional mitral regurgitation is associated with increased risk of death and heart failure re-hospitalization. The etiology, pathophysiology, and mechanism of atrial functional mitral regurgitation is not completely understood but they should not be regarded as the same as for the conventional type of functional mitral regurgitation secondary to left ventricular dilatation and dysfunction. Mitral annular dilatation, atriogenic leaflet distortion, insufficient leaflet remodeling, and subtle left ventricular dysfunction may play a role in the pathogenesis of atrial functional mitral regurgitation. The therapeutic and surgical considerations of atrial functional mitral regurgitation are different from those of ventricular functional mitral regurgitation. In this review, we assess current evidence regarding this new disease entity and propose a new surgical approach based on up-to-date understanding and experience of this condition.

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Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 94%

Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 96%

Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 99%

Section: Prevalence Clinical Characteristics and Outcomementioning

confidence: 99%

See 2 more Smart Citations

Atrial functional mitral regurgitation: mechanisms and surgical implications

Fan

Wan

Wong

et al. 2020

Asian Cardiovasc Thorac Ann

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“…A trial fibrillation (AF) is a common type of arrhythmia that has high risks for mortality, impaired cardiac function, and thromboembolism, especially cardioembolic stroke. [1][2][3][4][5][6][7] AF is a predictive factor for severe stroke and early death in patients with acute ischemic stroke. 8) The prevalence of AF increases as people age.…”

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confidence: 99%

Low Consultation Rate of General Population with Atrial Fibrillation

Matsumi

2019

Int. Heart J.

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In order to prevent ischemic stroke, it is important to identify and treat patients with atrial fibrillation (AF) who do not consult a doctor in a medical institution. The aim of this study was to determine the consultation rate at medical institutions for patients with AF in group medical examinations conducted in a city in western Japan. Of 6101 examinees of group medical examinations (40 years of age or older) conducted in Ibara City, Okayama Prefecture, Japan, from 2012 to 2014, 4338 participants (71.1%) who were evaluated by electrocardiogram (ECG) gave written informed consent and responded to surveys in the form of questionnaires through a personal interview conducted by nurses were included in the Ibara-AF study. A cumulative total of 82 subjects were diagnosed as having AF by ECG (prevalence of AF = 1.89%), and 51 individuals had AF during the three-year period. 15 (29.4%) of the 51 patients with AF did not regularly visit medical institutions. Among them, 46.7% (n = 7) and 53.3% (n = 8) of the patients were symptomatic and asymptomatic, respectively, and 73.3% of the patients had a CHADS2 score of more than one point. There were no significant differences in patients' characteristics between regular and non-regular visit groups. In conclusion, about one-third of the patients with AF did not regularly see a doctor in a medical institution and most of them had a CHADS2 score of more than one point in a Japanese rural area. Educating the public about the risks of AF is required.

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Outcomes of transcatheter edge‐to‐edge repair for atrial functional mitral regurgitation: A meta‐analysis of observational studies

Hamada,

Ueyama,

Aikawa

et al. 2023

Cathet Cardio Intervent

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BackgroundTranscatheter edge‐to‐edge repair (TEER) may have potential benefits in the treatment of atrial functional mitral regurgitation (AFMR), but robust evidence is currently lacking. We conducted a systematic review and meta‐analysis to investigate the clinical outcomes of TEER for AFMR, including comparisons to ventricular functional MR (VFMR).MethodsMEDLINE and EMBASE were searched through January 2023 to identify studies eligible for analysis. The primary outcome was postprocedural MR severity. Postprocedural New York Heart Association (NYHA) functional class classification and all‐cause mortality were also evaluated. Outcomes were stratified into short term (postprocedure to 6 months) and long term (6 months to 2 years).ResultsA total of eight observational studies met the inclusion criteria, enrolling 539 AFMR and 3486 VFMR patients. Postprocedural MR grade ≤2 in the AFMR group was observed in 93.7% (454/491 patients; 95% confidence interval (CI), 91.1%–96.2%, I2 = 24.3%) and 97.1% (89/93 patients; 95% CI, 92.9%–100%, I2 = 26.4%) in short‐ and long‐term follow‐up, respectively. There was no difference in the rates of postprocedural MR grade ≤2 between AFMR and VFMR either in short‐term (risk ratio [RR], 1.00 [95% CI, 0.95–1.06]; p = 0.90; I2 = 53%) or long‐term follow‐up (RR, 1.08 [95% CI, 0.89–1.32]; p = 0.44; I2 = 22%). Similarly, no difference was observed between AFMR and VFMR in the rates of postprocedural NYHA class ≤2 or all‐cause mortality.ConclusionTEER provides similar clinical outcomes for AFMR and VFMR. A high rate of MR grade ≤2 was observed in patients at both short‐ and long‐term follow‐ups. Further prospective studies with TEER versus medical therapy and/or rhythm control for AFMR are warranted.

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Prevalence, clinical characteristics, and outcome of atrial functional mitral regurgitation in hospitalized heart failure patients with atrial fibrillation

Abstract: AFMR was present in a proportion of elderly hospitalized HF patients with AF, and was a condition requiring attention because of readmission for HF in a hospitalized HF cohort.

Cited by 33 publications

References 41 publications

Atrial functional mitral regurgitation: mechanisms and surgical implications

Atrial functional mitral regurgitation: mechanisms and surgical implications

Low Consultation Rate of General Population with Atrial Fibrillation

Outcomes of transcatheter edge‐to‐edge repair for atrial functional mitral regurgitation: A meta‐analysis of observational studies

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