当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome.

Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome.

Abstract：

OBJECTIVES:The study was done to define the incidence, determinants and prognostic implications of onset of atrial fibrillation (AF) during follow-up of mitral regurgitation (MR) initially in sinus rhythm. BACKGROUND:The rates and clinical implications of AF in MR are undefined. METHODS:We analyzed the occurrence of AF under conservative management in two populations of patients with degenerative MR in sinus rhythm at diagnosis: 1) 360 patients (65 +/- 13 years, 74% men) with MR due to flail leaflets; and 2) 89 residents of Olmsted County, Minnesota (67 +/- 17 years, 56% men) with grade 3 or 4 MR due to simple mitral valve prolapse (MVP) diagnosed echocardiographically. RESULTS:In patients with MR due to flail leaflets, AF rates at 5 and 10 years were 18 +/- 3% and 48 +/- 6%, respectively, and the linearized rate was 5.0 +/- 0.7% per year. Development of AF during follow-up was independently associated with high risk of cardiac death or heart failure (adjusted risk ratio 2.23, p = 0.025). The AF rate at 10 years was higher in patients >or=65 years (75 +/- 10% vs. 24 +/- 6%, p < 0.0001) and in those with baseline left atrial (LA) dimension >or=50 mm (67 +/- 8% vs. 37 +/- 9%, p < 0.001). In multivariate analysis, independent baseline predictors of AF were age and LA diameter (both p < 0.01). In patients with MR due to MVP, similar rates of AF (41 +/- 7% vs. 44 +/- 6% at nine years, p > 0.50) and predictors of AF (age and LA dimension, both p < 0.006) were noted. CONCLUSIONS:In patients with degenerative MR in sinus rhythm at diagnosis, the incidence of AF occurring under conservative management is high and similar whether the cause of MR is flail leaflet or simple MVP. After onset of AF, an increased cardiac mortality and morbidity are both observed under conservative management. The risk of AF increases with advancing age and larger LA dimension. These data suggest that the clinical management of MR should take into account the high incidence, excess risk, and predictors of AF.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Grigioni F,Avierinos JF,Ling LH,Scott CG,Bailey KR,Tajik AJ,Frye RL,Enriquez-Sarano M

doi

10.1016/s0735-1097(02)01922-8

subject

Has Abstract

pub_date

2002-07-03 00:00:00

pages

84-92

issue

eissn

0735-1097

issn

1558-3597

pii

S0735109702019228

journal_volume

pub_type

杂志文章

在线工具

Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome.