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Differences in clinical and echocardiographic features and outcomes between atrial functional mitral regurgitation

Hiroki Okamoto1, Makoto Miyake2, Atsushi Hayashi3

  • 1Department of Internal Medicine Division of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan; Department of Cardiology, Tenri Hospital, Tenri, Nara, Japan.

Journal of Cardiology
|February 10, 2023
PubMed
Abstract

Insights

Posterior mitral leaflet bending in atrial functional mitral regurgitation (AFMR) patients is linked to worse cardiac outcomes. This finding emerged despite similar clinical features between groups, highlighting PML bending as a potential prognostic indicator.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Valvular Heart Disease

Background:

  • Posterior mitral leaflet (PML) bending is a recognized cause of atrial functional mitral regurgitation (AFMR).
  • Understanding the clinical implications of PML bending in AFMR is crucial for patient management.

Purpose of the Study:

  • To investigate differences in clinical, echocardiographic features, and outcomes between AFMR patients with and without PML bending.

Main Methods:

  • Retrospective analysis of 118 AFMR patients with atrial fibrillation and preserved ejection fraction.
  • Classification into PML bending (n=24) and no PML bending (n=94) groups based on a defined angle ratio.
  • Primary endpoint: composite of cardiac death, heart failure admission, or mitral valve surgery.

Main Results:

  • No significant differences in clinical or echocardiographic characteristics, except for left ventricular posterobasal wall bending and mitral annular area.
  • 36-month event-free survival was significantly lower in the PML bending group (63% vs. 78%, p=0.047).
  • Multivariate analysis confirmed PML bending as an independent predictor of adverse outcomes.

Conclusions:

  • AFMR patients with PML bending exhibit poorer clinical outcomes compared to those without.
  • PML bending may serve as a significant prognostic marker in AFMR, even with similar baseline clinical profiles.
Keywords:
Atrial fibrillationEchocardiographyMitral regurgitationPosterior leaflet bending

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