What is the clinical evidence from this study?

Study design: Observational. Population: Rheumatic mitral stenosis (n=603). Primary outcome: Atrial fibrillation (OR 7.53, 95% CI 4.47-12.69, p=<0.001).

What does this research mean for the field?

Left atrial strain, right atrial pressure, age, and ejection fraction independently predict atrial fibrillation in patients with rheumatic mitral stenosis and can be combined into a highly accurate predictive model. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To establish a mathematical model to predict the risk of atrial fibrillation in patients diagnosed with rheumatic mitral valve stenosis.

April 2, 2014Asian Cardiovascular and Thoracic Annals

Factors associated with atrial fibrillation in rheumatic mitral stenosis

Q: What are the key findings of this study?

Left atrial strain (OR 7.53; 95% CI 4.47-12.69), right atrial pressure, age, and ejection fraction independently predicted atrial fibrillation in patients with rheumatic mitral stenosis.

Q: What does this research mean for the field?

Left atrial strain, right atrial pressure, age, and ejection fraction independently predict atrial fibrillation in patients with rheumatic mitral stenosis and can be combined into a highly accurate predictive model. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To establish a mathematical model to predict the risk of atrial fibrillation in patients diagnosed with rheumatic mitral valve stenosis.

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Key result

Left atrial strain (OR 7.53; 95% CI 4.47-12.69), right atrial pressure, age, and ejection fraction independently predicted atrial fibrillation in patients with rheumatic mitral stenosis.

Population

603 patients with rheumatic mitral stenosis

Design

Cross-sectional

Authors

LPLeili PourafkariCardiac Imaging SGSamad GhaffariTabriz University of Medical Sciences GBGeorge R BancroftUniversity at Buffalo, State University of New York

Discussion

Member takes

Implication

May aid AF risk stratification in rheumatic mitral stenosis; hypothesis-generating and requires prospective validation before clinical use.

Key Points

To establish a mathematical model to predict the risk of atrial fibrillation in patients diagnosed with rheumatic mitral valve stenosis.
Screened 819 patients with mitral stenosis and enrolled 603 individuals categorized by cardiac rhythm (sinus rhythm vs. atrial fibrillation).
Recorded demographic, echocardiographic, and hemodynamic parameters.
Constructed multivariable logistic regression models and evaluated predictive performance using receiver operating characteristic (ROC) curves.
Overall, 200 of 603 patients (33%) presented with atrial fibrillation, showing older age, higher functional class, prior thromboembolism, and reduced ejection fraction.
Independent predictors of atrial fibrillation were left atrial strain (OR = 7.53, 95% CI [4.47–12.69], p < 0.001), right atrial pressure (OR = 1.09, 95% CI [1.02–1.17], p = 0.01), age (OR = 1.14, 95% CI [1.05–1.25], p = 0.002), and ejection fraction (OR = 0.92, 95% CI [0.87–0.97], p = 0.003).
The multivariable predictive model demonstrated high diagnostic accuracy, with an area under the ROC curve (AUC) of 0.90 ± 0.12.

Study Design

Type

Observational (n=603)

Structured PICO

Population

603 patients with rheumatic mitral stenosis

Outcome

Presence of atrial fibrillation

Main Result

Effect estimate: OR 7.53 (95% CI 4.47-12.69)

p-value: p=<0.001

A mathematical model incorporating age, right atrial pressure, ejection fraction, and left atrial strain can accurately predict the presence of atrial fibrillation in patients with rheumatic mitral stenosis.

Cite This Study

Pourafkari et al. (2014) conducted an observational in Rheumatic mitral stenosis (n=603). Left atrial strain (OR 7.53; 95% CI 4.47-12.69), right atrial pressure, age, and ejection fraction independently predicted atrial fibrillation in patients with rheumatic mitral stenosis.

synapsesocial.com/papers/6a159faa79ff98d0de4ee7d4 https://doi.org/10.1177/0218492314530134

Topics

Atrial fibrillation Persistent AF management

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Implication

May aid AF risk stratification in rheumatic mitral stenosis; hypothesis-generating and requires prospective validation before clinical use.

Factors associated with atrial fibrillation in rheumatic mitral stenosis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Factors associated with atrial fibrillation in rheumatic mitral stenosis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider