Impact of preprocedural atrial fibrillation on immediate and long-term outcomes after successful percutaneous mitral valvuloplasty of significant mitral stenosis

Shiro Miura, Takeshi Arita, Takenori Domei, Kyohei Yamaji, Yoshimitsu Soga, Makoto Hyodo, Shinichi Shirai, Kenji Ando

Research output: Contribution to journalArticle

Abstract

Optimal time to perform percutaneous mitral valvuloplasty (PMV) for patients with significant mitral stenosis (MS) and atrial fibrillation (AF) remains controversial. We sought to identify prognostic factors and evaluate long-term clinical outcomes after PMV of 77 consecutive patients with MS with a mitral valve area (MVA) <1.5 cm2. According to baseline heart rhythm, these patients were divided into sinus rhythm (SR; n = 24) and AF (n = 53) groups. The study endpoint was defined as a composite of all-cause mortality, admission for heart failure, mitral valve surgery, repeated PMV, and major cerebral vascular accident during follow-up. After successful PMV, there was no significant difference between the two groups in post-MVA and post-mitral mean pressure gradient. However, the New York Heart Association Functional Classification post-procedure was worse in the AF group (p < 0.01). In the AF group, event-free survival during follow-up was significantly lower compared with that of the SR group (p = 0.016). Independent predictors of clinical events were AF [hazard ratio (HR), 2.73; 95 % confidence interval (CI), 1.04–9.36; p = 0.03] and pulmonary artery systolic pressure (HR 2.57; 95 % CI 1.18–5.47; p = 0.017). Patients with AF at baseline were significantly associated with worse symptoms and higher event rates after successful PMV compared with those with SR. The clinical benefit of PMV may be considered for patients with MVA <1.5 cm2 before the onset of AF.

Original languageEnglish
Pages (from-to)46-54
Number of pages9
JournalCardiovascular Intervention and Therapeutics
Volume33
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Mitral Valve Stenosis
Atrial Fibrillation
Mitral Valve
Confidence Intervals
Pulmonary Artery
Disease-Free Survival
Accidents
Blood Vessels
Heart Failure
Blood Pressure
Pressure
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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Impact of preprocedural atrial fibrillation on immediate and long-term outcomes after successful percutaneous mitral valvuloplasty of significant mitral stenosis. / Miura, Shiro; Arita, Takeshi; Domei, Takenori; Yamaji, Kyohei; Soga, Yoshimitsu; Hyodo, Makoto; Shirai, Shinichi; Ando, Kenji.

In: Cardiovascular Intervention and Therapeutics, Vol. 33, No. 1, 01.01.2018, p. 46-54.

Research output: Contribution to journalArticle

Miura, Shiro ; Arita, Takeshi ; Domei, Takenori ; Yamaji, Kyohei ; Soga, Yoshimitsu ; Hyodo, Makoto ; Shirai, Shinichi ; Ando, Kenji. / Impact of preprocedural atrial fibrillation on immediate and long-term outcomes after successful percutaneous mitral valvuloplasty of significant mitral stenosis. In: Cardiovascular Intervention and Therapeutics. 2018 ; Vol. 33, No. 1. pp. 46-54.
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AU - Yamaji, Kyohei

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AU - Hyodo, Makoto

AU - Shirai, Shinichi

AU - Ando, Kenji

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