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Atrial functional mitral regurgitation may develop in AF patients
Gertz Z. J Am Coll Cardiol. 2011;58:1474-1481.
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Patients with atrial fibrillation and an enlarged mitral annulus may be at risk for developing atrial functional mitral regurgitation that can be improved if sinus rhythm is restored, according to study results.
Researchers screened patients undergoing first AF ablation at the University of Pennsylvania Heath System between June 2003 and December 2008 to determine whether AF is associated with atrial functional mitral regurgitation. Patients with moderate mitral regurgitation were included in the mitral regurgitation cohort (n=53), whereas patients with mild or less mitral regurgitation were randomly assigned to a reference cohort (n=53). A transthoracic echocardiogram was performed within 3 days of catheter ablation and at 1-year clinical follow-up to assess the effect of restoration of sinus rhythm.
According to the results, patients with mitral regurgitation were older, more likely to have persistent AF and more frequently had hypertension (P<.0001). At baseline echocardiogram, 97% of patients were in sinus rhythm. There were 19% of patients in sinus rhythm who had trace or no mitral regurgitation vs. 0% in the recurrence group; 57% of patients in the sinus rhythm group had mitral regurgitation at follow-up vs. 18% in the recurrence group. There was a decline in left atrium size in patients whose sinus rhythm was maintained after ablation (P=.02). A small increase in mitral regurgitation degree was seen in patients with recurrence (P=.01) vs. in patients without recurrence who had no mitral regurgitation degree change (P=.62).
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