Arrhythmias & electrophysiology
Potential Effects of Mild Atrial Secondary Mitral Regurgitation in Patients With Isolated Atrial Fibrillation
Authors' conclusion
In the presence of isolated AF and no compensatory LV dilatation, impaired hemodynamics and higher risks of symptomatic HF deterioration were associated with mild asMR, requiring further studies of causalities.
Study context
- Population
- Patients with isolated AF (atrial secondary mitral regurgitation (asMR) no/trivial, mild or moderate; none severe) and healthy controls142 isolated AF, 30 healthy controls
- Participants
- 30 / 55 / 83
- Exposure
- Mild asMR vs no/trivial asMR vs healthy controls
- Controlsn = 30reference
- No/trivial asMRn = 55
- Mild asMRn = 83
- Outcome
- Echocardiographic hemodynamics: LV end-diastolic volume index, stroke volume index, cardiac output index, systolic pulmonary artery pressure
Main finding
As reported in the abstract
Echocardiographic hemodynamics
| Group | Left ventricular (LV) end-diastolic volume index | Stroke volume index | Cardiac output index | Systolic pulmonary artery pressure |
|---|---|---|---|---|
| Controls | 65±6 mL/m² | 42±4 mL/m² | 2.8±0.4 L/min per m² | 21±3 mm Hg |
| No/trivial asMR | 58±8 mL/m² | 35±4 mL/m² | 2.8±0.5 L/min per m² | 26±5 mm Hg |
| Mild asMR | 60±8 mL/m² | 29±6 mL/m² | 2.3±0.6 L/min per m² | 37±9 mm Hg |
Left ventricular (LV) end-diastolic volume index
Controls65±6 mL/m²
No/trivial asMR58±8 mL/m²
Mild asMR60±8 mL/m²
Stroke volume index
Controls42±4 mL/m²
No/trivial asMR35±4 mL/m²
Mild asMR29±6 mL/m²
Cardiac output index
Controls2.8±0.4 L/min per m²
No/trivial asMR2.8±0.5 L/min per m²
Mild asMR2.3±0.6 L/min per m²
Systolic pulmonary artery pressure
Controls21±3 mm Hg
No/trivial asMR26±5 mm Hg
Mild asMR37±9 mm Hg
- Mild asMR vs Controls and No/trivial asMR: P < 0.001 — stroke volume index
- Mild asMR vs Controls and No/trivial asMR: P < 0.001 — cardiac output index
- Mild asMR vs Controls and No/trivial asMR: P < 0.001 — systolic pulmonary artery pressure
Observational data: associations, not effects.
Further findings
| Outcome | No/trivial asMR | Mild asMR | P value |
|---|---|---|---|
| Event-free rate of HF symptomatic deterioration / HF hospitalization · median 13.9 months follow-upHF symptomatic deterioration | P < 0.001 | ||
| Free of HF symptomatic deterioration | 86.9% | 59.4% | |
| Free of HF hospitalization | 100% | 85.0% | |
| Event-free rate of HF symptomatic deterioration / HF hospitalization · median 13.9 months follow-upHF hospitalization | P = 0.032 |
Original publication
Potential Effects of Mild Atrial Secondary Mitral Regurgitation in Patients With Isolated Atrial Fibrillation. Circ Cardiovasc Imaging. Published 28 February 2024. doi:10.
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