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Aortic stenosis and mitral regurgitation as predictors of atrial fibrillation during 11 years of follow-up

Widgren, Veronica; Dencker, Magnus LU ; Juhlin, Tord LU ; Platonov, Pyotr LU and Willenheimer, Ronnie LU (2012) In BMC Cardiovascular Disorders 12(92).
Abstract
Background: There is limited information about any association between the onset of atrial fibrillation (AF) and the presence of valvular disease. Methods: We retrospectively examined 940 patients in sinus rhythm, examined by echocardiography in 1996. During 11 years of follow-up, we assessed the incidence of AF and outcome defined as valvular surgery or death, in relation to baseline valvular function. AS (aortic stenosis) severity at baseline examination was assessed using peak transaortic valve pressure gradient. Results: In univariate analysis, the risk of developing AF was related to AS (significant AS versus no significant AS; hazard ratio (HR) 3.73, 95% confidence interval (CI) 2.39-5.61, p<0.0001) and mitral regurgitation (MR)... (More)
Background: There is limited information about any association between the onset of atrial fibrillation (AF) and the presence of valvular disease. Methods: We retrospectively examined 940 patients in sinus rhythm, examined by echocardiography in 1996. During 11 years of follow-up, we assessed the incidence of AF and outcome defined as valvular surgery or death, in relation to baseline valvular function. AS (aortic stenosis) severity at baseline examination was assessed using peak transaortic valve pressure gradient. Results: In univariate analysis, the risk of developing AF was related to AS (significant AS versus no significant AS; hazard ratio (HR) 3.73, 95% confidence interval (CI) 2.39-5.61, p<0.0001) and mitral regurgitation (MR) (significant MR versus no significant MR; HR 2.52, 95% CI 1.77-3.51, p<0.0001). Also the risk of valvular surgery or death was related to AS (HR 3.90, 95% CI 3.09-4.88, p<0.0001) and MR (HR 2.07, 95% CI 1.67-2.53, p<0.0001). In multivariate analyses, adjusting for sex, age, other valvular abnormalities, left ventricular ejection fraction and left atrial size - AS was independently related to both endpoints, whereas MR was not independently related to either endpoint. Conclusions: AS, but not MR, was independently predictive of development of AF and combined valvular surgery or death. In patients with combined AS and MR, the grade of AS, more than the grade of MR, determined the risk of AF and combination of valvular surgery or death. Further studies using contemporary echocardiographic quantification of aortic stenosis are warranted to confirm these retrospective data based on peak transaortic valve pressure gradient. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial fibrillation, Aortic stenosis, Mitral regurgitation, Valvular, heart disease, Remodelling
in
BMC Cardiovascular Disorders
volume
12
issue
92
publisher
BioMed Central
external identifiers
  • wos:000312312300001
  • scopus:84867500312
ISSN
1471-2261
DOI
10.1186/1471-2261-12-92
language
English
LU publication?
yes
id
06133e61-5340-4706-882c-95ab4b4cb57a (old id 3371944)
date added to LUP
2013-02-01 06:58:55
date last changed
2017-01-01 05:28:30
@article{06133e61-5340-4706-882c-95ab4b4cb57a,
  abstract     = {Background: There is limited information about any association between the onset of atrial fibrillation (AF) and the presence of valvular disease. Methods: We retrospectively examined 940 patients in sinus rhythm, examined by echocardiography in 1996. During 11 years of follow-up, we assessed the incidence of AF and outcome defined as valvular surgery or death, in relation to baseline valvular function. AS (aortic stenosis) severity at baseline examination was assessed using peak transaortic valve pressure gradient. Results: In univariate analysis, the risk of developing AF was related to AS (significant AS versus no significant AS; hazard ratio (HR) 3.73, 95% confidence interval (CI) 2.39-5.61, p&lt;0.0001) and mitral regurgitation (MR) (significant MR versus no significant MR; HR 2.52, 95% CI 1.77-3.51, p&lt;0.0001). Also the risk of valvular surgery or death was related to AS (HR 3.90, 95% CI 3.09-4.88, p&lt;0.0001) and MR (HR 2.07, 95% CI 1.67-2.53, p&lt;0.0001). In multivariate analyses, adjusting for sex, age, other valvular abnormalities, left ventricular ejection fraction and left atrial size - AS was independently related to both endpoints, whereas MR was not independently related to either endpoint. Conclusions: AS, but not MR, was independently predictive of development of AF and combined valvular surgery or death. In patients with combined AS and MR, the grade of AS, more than the grade of MR, determined the risk of AF and combination of valvular surgery or death. Further studies using contemporary echocardiographic quantification of aortic stenosis are warranted to confirm these retrospective data based on peak transaortic valve pressure gradient.},
  author       = {Widgren, Veronica and Dencker, Magnus and Juhlin, Tord and Platonov, Pyotr and Willenheimer, Ronnie},
  issn         = {1471-2261},
  keyword      = {Atrial fibrillation,Aortic stenosis,Mitral regurgitation,Valvular,heart disease,Remodelling},
  language     = {eng},
  number       = {92},
  publisher    = {BioMed Central},
  series       = {BMC Cardiovascular Disorders},
  title        = {Aortic stenosis and mitral regurgitation as predictors of atrial fibrillation during 11 years of follow-up},
  url          = {http://dx.doi.org/10.1186/1471-2261-12-92},
  volume       = {12},
  year         = {2012},
}