Usefulness of preoperative atrial fibrillation to predict outcome and left ventricular dysfunction after valve repair for mitral valve prolapse

The American Journal of Cardiology
Catherine SzymanskiChristophe Tribouilloy

Abstract

The aim of the study was to assess the impact of atrial fibrillation (AF) on outcome in patients who underwent mitral valve repair (MVRp) for mitral valve prolapse (MVP). Four hundred and forty-three consecutive patients underwent MVRp for organic mitral regurgitation due to MVP. Echocardiography was performed preoperatively and after surgery. Postoperative left ventricular dysfunction (LVD) was defined as left ventricular ejection fraction (LVEF) <50%. Before surgery, 187 patients (42%) had preoperative AF. After surgery, LVEF significantly decreased from 67 ± 9% to 56 ± 10% (p <0.0001). Compared with patients in sinus rhythm (SR), those in AF were significantly older (p <0.0001), had more severe symptoms (p = 0.004), had lower LVEF (p = 0.002), and higher EuroSCORE (p = 0.05). Compared with patients in SR, patients with AF had significantly lower 10-year survival (64 ± 4% vs 83 ± 3%, p = 0.001). On multivariate analysis, preoperative AF was identified as an independent predictor of overall mortality (hazard ratio 1.67; 95% confidence interval 1.15 to 2.42; p = 0.007). At 10 years, patients with paroxysmal AF had lower survival and higher heart failure rate than patients in SR (78 ± 3% vs 66 ± 6%) but had a better outcome comp...Continue Reading

Associated Clinical Trials

References

Aug 1, 1997·The Journal of Thoracic and Cardiovascular Surgery·J F ObadiaJ F Chassignolle
May 18, 2000·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·E R JessurunJ M Ernst
May 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·Ko BandoSoichiro Kitamura
Aug 7, 2010·Journal of the American College of Cardiology·Thierry Le TourneauMaurice Enriquez-Sarano
Jul 9, 2011·Circulation. Cardiovascular Imaging·Dan RusinaruUNKNOWN Mitral Regurgitation International DAtabase (MIDA) Investigators

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Citations

Jan 27, 2019·Journal of the American College of Cardiology·Francesco GrigioniUNKNOWN MIDA Investigators
Jun 23, 2021·Journal of the American Heart Association·Jordan E MorningstarRussell A Norris
Aug 29, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alec VahanianUNKNOWN ESC/EACTS Scientific Document Group
Aug 29, 2021·European Heart Journal·Alec VahanianUNKNOWN ESC Scientific Document Group

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