Valvular & structural heart disease
Atrial Dysfunction in Significant Atrial Functional Mitral Regurgitation: Phenotypes and Prognostic Implications
Authors' conclusion
LA reservoir function but not LA size is a robust predictor of outcome in significant AFMR.
Study context
- Population
- Consecutive patients with significant (moderate or greater) atrial functional mitral regurgitation, single institution, 2001–2019
- Participants
- 515 patients
- Exposure
- Low vs high left atrial (LA) reservoir strain and estimated reservoir work
- Outcome
- All-cause death or HF hospitalizations
- Follow-up
- 5 (1-17) years
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
All-cause death
Hazard ratio (95% CI)P value
Low LASr vs High LASr
2.3(1.6–3.5)
P < 0.001Low LAWr vs High LAWr
3.4(2.4–4.9)
P < 0.001- Low LASr or LAWr: higher risk of death
- P < 0.001
- Low LASr or LAWr: higher risk of HF hospitalization
- P < 0.05
Observational data: associations, not effects.
Further findings
Phenotypes
Phenotypes
- LA volume largest in atrial fibrillation (AF); LA function most impaired in heart failure with preserved ejection fraction (HFpEF)+AF
Death, by phenotype (subgroup)
- Low LASr and LAWr most strongly associated with death in HFpEF and HFpEF+AF
Original publication
Atrial Dysfunction in Significant Atrial Functional Mitral Regurgitation: Phenotypes and Prognostic Implications. Circ Cardiovasc Imaging. Published 9 May 2023. doi:10.
Summarised from the published abstract; every number is checked against it