What question did this study set out to answer?

To evaluate clinical characteristics and echocardiographic left atrial changes in severe mitral stenosis patients maintaining sinus rhythm for at least a decade after successful balloon valvuloplasty.

January 1, 2018CardiologyOpen Access

Different Characteristics, Clinical Outcomes, and Left Atrial Reverse Remodeling in Patients with Mitral Stenosis Maintaining Sinus Rhythm for at Least 10 Years after Successful Percutaneous Mitral Valvuloplasty

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Severe mitral stenosis (n=107). Intervention: Preprocedural atrial fibrillation vs. Preprocedural sinus rhythm. Primary outcome: Presence of atrial fibrillation after successful PMV (OR 14.50, p=0.001).

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Key result

Preprocedural atrial fibrillation (OR 14.50, p=0.001) and left atrial diameter ≥50 mm (OR 8.81, p<0.001) were independently associated with increased risk of atrial fibrillation after successful PMV.

Why the study?

Does maintaining sinus rhythm for at least 10 years after successful percutaneous mitral valvuloplasty improve left atrial reverse remodeling in patients with severe mitral stenosis?

Population

107 patients with severe mitral stenosis who had successful percutaneous mitral balloon valvuloplasty and…

Comparison

Maintenance of sinus rhythm for at least 10… vs Presence of atrial fibrillation after successful…

Design

Cohort

Follow-up

15 ± 4 years for SR patients and 16 ± 4 years for AF…

Authors

ICIn‐Jeong ChoCedars-Sinai Medical Center SKSoo-Jin KimKookmin University DHDonghee HanCedars-Sinai Medical Center

Discussion

Member takes

Implication

Suggests early intervention before left atrial diameter reaches 50 mm may maximize long-term.

Key Points

To evaluate clinical characteristics and echocardiographic left atrial changes in severe mitral stenosis patients maintaining sinus rhythm for at least a decade after successful balloon valvuloplasty.
Retrospectively analyzed 107 patients who underwent successful percutaneous mitral valvuloplasty without subsequent mitral valve surgery and completed at least 10 years of echocardiographic follow-up.
Tracked preprocedural, immediate postprocedural, and long-term echocardiographic parameters across sinus rhythm (mean follow-up 15 ± 4 years) and atrial fibrillation cohorts (mean follow-up 16 ± 4 years).
Left atrial diameter significantly decreased in patients maintaining sinus rhythm (n = 50; 46.7 ± 6.3 mm pre-procedure vs. 43.3 ± 6.2 mm at follow-up) but significantly enlarged in those with atrial fibrillation (n = 57; 53.9 ± 7.1 mm vs. 58.1 ± 8.7 mm).
Multivariate analysis demonstrated that preprocedural atrial fibrillation (OR 14.50, p = 0.001) and baseline left atrial diameter ≥50 mm (OR 8.81, p < 0.001) independently predicted long-term atrial fibrillation after successful valvuloplasty.

Study Design

Type

Cohort (n=107)

Structured PICO

Does maintaining sinus rhythm for at least 10 years after successful percutaneous mitral valvuloplasty improve left atrial reverse remodeling in patients with severe mitral stenosis?

Population

107 patients with severe mitral stenosis who had successful percutaneous mitral balloon valvuloplasty and follow-up echocardiography for at least 10 years without mitral valve surgery.

Exposure

Maintenance of sinus rhythm (SR) for at least 10 years after successful PMV (n=50)

Comparator

Presence of atrial fibrillation (AF) after successful PMV (n=57)

Outcome

Characteristics and echocardiographic changes (specifically left atrial diameter) at long-term follow-up (at least 10 years)surrogate

Main Result

Odds Ratio: 14.5

p-value: p=0.001

Very long-term maintenance of sinus rhythm after successful percutaneous mitral valvuloplasty is associated with left atrial reverse remodeling and is predicted by preprocedural sinus rhythm and LA diameter < 50 mm.

Cite This Study

Cho et al. (2018) conducted a cohort in Severe mitral stenosis (n=107). Preprocedural atrial fibrillation vs. Preprocedural sinus rhythm was evaluated on Presence of atrial fibrillation after successful PMV (OR 14.50, p=0.001). Preprocedural atrial fibrillation (OR 14.50, p=0.001) and left atrial diameter ≥50 mm (OR 8.81, p<0.001) were independently associated with increased risk of atrial fibrillation after successful PMV.

synapsesocial.com/papers/6a8ddcbb2fb87b53917ff459 https://doi.org/10.1159/000486708

Topics

Atrial fibrillation Persistent AF management Echocardiography AF ablation outcomes

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Different Characteristics, Clinical Outcomes, and Left Atrial Reverse Remodeling in Patients with Mitral Stenosis Maintaining Sinus Rhythm for at Least 10 Years after Successful Percutaneous Mitral Valvuloplasty

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Different Characteristics, Clinical Outcomes, and Left Atrial Reverse Remodeling in Patients with Mitral Stenosis Maintaining Sinus Rhythm for at Least 10 Years after Successful Percutaneous Mitral Valvuloplasty

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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