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Atrial fibrillation in aortic stenosis--echocardiographic assessment and prognostic importance

Charlotte Burup Kristensen1, Jan Skov Jensen, Peter Sogaard

  • 1Copenhagen University Hospital Gentofte, Department of Cardiology P835, Niels Andersens vej 65, DK-2900, Hellerup, Denmark. charlotte.burup@gmail.com

Cardiovascular Ultrasound
|September 26, 2012
PubMed

Insights

Atrial fibrillation (AFib) is an independent risk factor for mortality in patients with aortic stenosis (AS). This finding holds true regardless of the severity of aortic stenosis, highlighting AFib as a critical prognostic indicator.

Area of Science:

  • Cardiology
  • Clinical Echocardiography
  • Cardiac Electrophysiology

Background:

  • Atrial fibrillation (AFib) is more prevalent in patients with aortic stenosis (AS) and may indicate disease progression.
  • Echocardiographic assessment of AS in sinus rhythm is established, but AFib's role in AS prognosis is understudied due to trial exclusions.

Purpose of the Study:

  • To investigate the prognostic significance of atrial fibrillation (AFib) in patients diagnosed with aortic stenosis (AS).

Main Methods:

  • A single-center case-control study matched 103 patients with AS and AFib to 103 patients with AS and sinus rhythm.
  • Matching criteria included age, gender, and AS severity. Primary outcome was all-cause mortality with complete follow-up.

Main Results:

  • Patients with AFib exhibited lower ejection fraction and stroke volume, but higher heart rates compared to controls.
  • AFib was an independent predictor of mortality (HR 2.72), even after adjusting for echocardiographic differences.
  • The prognostic impact of AFib on mortality risk was consistent across all severities of AS.

Conclusions:

  • Atrial fibrillation (AFib) is an independent risk factor for mortality in patients with aortic stenosis (AS).
  • The prognostic impact of AFib in AS patients is independent of the stenosis severity.
Abstract

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