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Left atrial volume: predictor of atrial fibrillation in patients with degenerative mitral regurgitation.
J Heart Valve Dis 2007; 16(1):8-12JH

Abstract

BACKGROUND AND AIM OF THE STUDY

In patients with mitral regurgitation (MR) due to degenerative mitral valve prolapse (MVP), preoperative atrial fibrillation (AF) has been identified as an independent predictor of survival after surgery for MR. Thus, the determinants of preoperative AF may have critical implications to evaluate the timing of mitral valve repair. The study aim was to investigate the role of left atrial (LA) volume in predicting preoperative AF in patients with severe MR due to degenerative MVP.

METHODS

Sixty-six patients with severe degenerative MR (regurgitant volume > or =60 ml, regurgitant fraction > or =50%, effective regurgitant orifice area > or =0.4 cm(2)) in sinus rhythm (SR) at diagnosis and conservatively managed were eligible for the study. Complete two-dimensional (2-D) echocardiographic and Doppler measurements, including the measurement of maximum LA volume, were performed in all patients.

RESULTS

During follow up under conservative management (18.1+/-4.8 months), eight patients (12%) experienced conversion to AF, and 58 remained in SR. The mean LA dimension was 4.0+/-0.5 cm in patients with SR, and 5.1+/-0.8 cm in those who developed AF (p <0.0001). The mean LA volume and LA volume index (indexed to body surface area) were 95 +/-23 ml and 60+/-14 ml/m(2) respectively in patients with SR, and 166+/-66 ml and 104+/-42 ml/m(2) respectively in those who developed AF (both p <0.0001). The optimal cut-off value for LA volume to predict AF conversion was 117.5 ml (sensitivity 88%, specificity 83%), and for LA volume index was 75 ml/m(2) (sensitivity 88%, specificity 88%).

CONCLUSION

LA volume measurement should be considered in patients with degenerative severe MR diagnosed in SR. A LA volume index > or =75 ml/m(2) reflects the risk of subsequent AF, and patients should be closely monitored.

Authors+Show Affiliations

Division of Cardiology, Kobe General Hospital, 4-6 Minatojima-nakamachi, Cyuo-ku, Kobe 650-0046, Japan. ktanabe@leto.eonet.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17315377

Citation

Tanabe, Kazuaki, et al. "Left Atrial Volume: Predictor of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation." The Journal of Heart Valve Disease, vol. 16, no. 1, 2007, pp. 8-12.
Tanabe K, Yamaguchi K, Tani T, et al. Left atrial volume: predictor of atrial fibrillation in patients with degenerative mitral regurgitation. J Heart Valve Dis. 2007;16(1):8-12.
Tanabe, K., Yamaguchi, K., Tani, T., Yagi, T., Katayama, M., Tamita, K., ... Kihara, Y. (2007). Left atrial volume: predictor of atrial fibrillation in patients with degenerative mitral regurgitation. The Journal of Heart Valve Disease, 16(1), pp. 8-12.
Tanabe K, et al. Left Atrial Volume: Predictor of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation. J Heart Valve Dis. 2007;16(1):8-12. PubMed PMID: 17315377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left atrial volume: predictor of atrial fibrillation in patients with degenerative mitral regurgitation. AU - Tanabe,Kazuaki, AU - Yamaguchi,Kazuto, AU - Tani,Tomoko, AU - Yagi,Toshikazu, AU - Katayama,Minako, AU - Tamita,Koichi, AU - Kinoshita,Makoto, AU - Kaji,Shuichiro, AU - Yamamuro,Atsushi, AU - Morioka,Shigefumi, AU - Okada,Yukikatsu, AU - Kihara,Yasuki, PY - 2007/2/24/pubmed PY - 2007/3/7/medline PY - 2007/2/24/entrez SP - 8 EP - 12 JF - The Journal of heart valve disease JO - J. Heart Valve Dis. VL - 16 IS - 1 N2 - BACKGROUND AND AIM OF THE STUDY: In patients with mitral regurgitation (MR) due to degenerative mitral valve prolapse (MVP), preoperative atrial fibrillation (AF) has been identified as an independent predictor of survival after surgery for MR. Thus, the determinants of preoperative AF may have critical implications to evaluate the timing of mitral valve repair. The study aim was to investigate the role of left atrial (LA) volume in predicting preoperative AF in patients with severe MR due to degenerative MVP. METHODS: Sixty-six patients with severe degenerative MR (regurgitant volume > or =60 ml, regurgitant fraction > or =50%, effective regurgitant orifice area > or =0.4 cm(2)) in sinus rhythm (SR) at diagnosis and conservatively managed were eligible for the study. Complete two-dimensional (2-D) echocardiographic and Doppler measurements, including the measurement of maximum LA volume, were performed in all patients. RESULTS: During follow up under conservative management (18.1+/-4.8 months), eight patients (12%) experienced conversion to AF, and 58 remained in SR. The mean LA dimension was 4.0+/-0.5 cm in patients with SR, and 5.1+/-0.8 cm in those who developed AF (p <0.0001). The mean LA volume and LA volume index (indexed to body surface area) were 95 +/-23 ml and 60+/-14 ml/m(2) respectively in patients with SR, and 166+/-66 ml and 104+/-42 ml/m(2) respectively in those who developed AF (both p <0.0001). The optimal cut-off value for LA volume to predict AF conversion was 117.5 ml (sensitivity 88%, specificity 83%), and for LA volume index was 75 ml/m(2) (sensitivity 88%, specificity 88%). CONCLUSION: LA volume measurement should be considered in patients with degenerative severe MR diagnosed in SR. A LA volume index > or =75 ml/m(2) reflects the risk of subsequent AF, and patients should be closely monitored. SN - 0966-8519 UR - https://www.unboundmedicine.com/medline/citation/17315377/Left_atrial_volume:_predictor_of_atrial_fibrillation_in_patients_with_degenerative_mitral_regurgitation_ L2 - https://medlineplus.gov/atrialfibrillation.html DB - PRIME DP - Unbound Medicine ER -