PMID- 36792312
OWN - NLM
STAT- MEDLINE
DCOM- 20230217
LR  - 20230227
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 10
IP  - 1
DP  - 2023 Feb
TI  - Atrial functional mitral regurgitation: prevalence, characteristics and outcomes 
      from the National Echo Database of Australia.
LID - 10.1136/openhrt-2022-002180 [doi]
LID - e002180
AB  - AIMS: Atrial functional mitral regurgitation (AFMR) is characterised by left 
      atrial and consequent mitral annular dilatation causing mitral regurgitation. 
      AFMR is likely to become more common with population ageing, alongside increases 
      in atrial fibrillation and heart failure with preserved ejection fraction; 
      conditions causing atrial dilatation. Here, we aim to define the prevalence and 
      characterise the patient and survival characteristics of AFMR in the National 
      Echocardiographic Database of Australia (NEDA). METHODS AND RESULTS: 14 004 
      adults with moderate or severe FMR were identified from NEDA. AFMR or ventricular 
      FMR (VFMR) was classified by LA size, LV size and LVEF. AFMR was found in 40% 
      (n=5562) and VFMR in 60% (n=8442). Compared with VFMR, the AFMR subgroup were 
      significantly older (mean age 78+/-11 years), with a higher proportion of females 
      and of AF. Participants were followed up for a median of 65 months (IQR 36-116 
      months). After adjustment for age, sex, AF, and pulmonary hypertension, the 
      prognosis for VFMR was significantly worse than for AFMR (HR 1.57, 95% CI 1.47 to 
      1.68 for all-cause and 1.73, 95% CI 1.60 to 1.88, p<0.001 for both). After 
      further adjustment for LVEF, mortality rates were similar in VFMR and AFMR 
      patients (HR 0.93, p=NS), though advancing age and pulmonary hypertension 
      remained independently associated with prognosis. CONCLUSIONS: AFMR is a common 
      cause of significant functional MR that predominantly affects elderly female 
      patients with AF. Advancing age and pulmonary hypertension independently 
      associated with survival in FMR. Prognosis was better in AFMR compared with VFMR; 
      however, this difference was accounted for by LV systolic impairment and not by 
      MR severity.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Moonen, Avalon
AU  - Moonen A
AUID- ORCID: 0000-0002-0039-3911
AD  - School of Medicine, The University of Sydney, Sydney, New South Wales, Australia.
FAU - Ng, Martin K C
AU  - Ng MKC
AD  - School of Medicine, The University of Sydney, Sydney, New South Wales, Australia.
AD  - Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South 
      Wales, Australia.
FAU - Playford, David
AU  - Playford D
AD  - School of Medicine, The University of Notre Dame Australia, Fremantle, Western 
      Australia, Australia.
FAU - Strange, Geoff
AU  - Strange G
AUID- ORCID: 0000-0001-6800-7119
AD  - School of Medicine, The University of Notre Dame Australia, Fremantle, Western 
      Australia, Australia.
FAU - Scalia, Gregory M
AU  - Scalia GM
AD  - The University of Queensland, Saint Lucia, Queensland, Australia.
AD  - Department of Cardiology, The Prince Charles Hospital, Chermside, Queensland, 
      Australia.
FAU - Celermajer, David S
AU  - Celermajer DS
AD  - School of Medicine, The University of Sydney, Sydney, New South Wales, Australia 
      David.Celermajer@health.nsw.gov.au.
AD  - Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South 
      Wales, Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
SB  - IM
MH  - Adult
MH  - Humans
MH  - Female
MH  - Aged
MH  - Aged, 80 and over
MH  - *Mitral Valve Insufficiency/diagnostic imaging/epidemiology
MH  - *Atrial Fibrillation/diagnosis/epidemiology/complications
MH  - Prevalence
MH  - *Hypertension, Pulmonary
MH  - Heart Atria
PMC - PMC9933756
OTO - NOTNLM
OT  - cardiomyopathies
OT  - echocardiography
OT  - mitral valve insufficiency
COIS- Competing interests: None declared.
EDAT- 2023/02/16 06:00
MHDA- 2023/02/18 06:00
PMCR- 2023/02/15
CRDT- 2023/02/15 21:02
PHST- 2022/10/26 00:00 [received]
PHST- 2023/01/30 00:00 [accepted]
PHST- 2023/02/15 21:02 [entrez]
PHST- 2023/02/16 06:00 [pubmed]
PHST- 2023/02/18 06:00 [medline]
PHST- 2023/02/15 00:00 [pmc-release]
AID - openhrt-2022-002180 [pii]
AID - 10.1136/openhrt-2022-002180 [doi]
PST - ppublish
SO  - Open Heart. 2023 Feb;10(1):e002180. doi: 10.1136/openhrt-2022-002180.