Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis
BackgroundThis study assessed the role of surgical ablation for atrial fibrillation (AF) in decreasing tricuspid regurgitation (TR) and right‐sided heart remodeling in patients after mitral valve procedure. Methods and ResultsBetween 1994 and 2014, 1568 consecutive patients with AF undergoing mitral...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004213 |
| _version_ | 1811334068410777600 |
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| author | Jiangang Wang Jie Han Yan Li Qing Ye Fei Meng Tiange Luo Baiyu Tian Haibo Zhang Yixin Jia Wen Zeng Chunlei Xu Wei Han Yuqing Jiao Xu Meng |
| author_facet | Jiangang Wang Jie Han Yan Li Qing Ye Fei Meng Tiange Luo Baiyu Tian Haibo Zhang Yixin Jia Wen Zeng Chunlei Xu Wei Han Yuqing Jiao Xu Meng |
| author_sort | Jiangang Wang |
| collection | DOAJ |
| description | BackgroundThis study assessed the role of surgical ablation for atrial fibrillation (AF) in decreasing tricuspid regurgitation (TR) and right‐sided heart remodeling in patients after mitral valve procedure. Methods and ResultsBetween 1994 and 2014, 1568 consecutive patients with AF undergoing mitral valve procedure were identified. In 26.0% (n=408), surgical ablation of AF was used. Propensity‐score matching (PSM) was performed on the basis of 41 known perioperative risk variables. Survival, reoperation, stroke, and moderate‐to‐severe TR, as well as echocardiography indices in long‐term follow‐up, were compared in 406 matched patient pairs (ablated and nonablated groups). The nonablated group showed significantly higher risks of death (hazard ratio [HR], 1.644; 95% CI, 1.081–2.501; P=0.020), reoperation (HR, 2.644; 95% CI, 1.299–5.466; P=0.008), and moderate‐to‐severe TR (HR, 1.436; 95% CI, 1.059–1.948; P=0.020), associated with a significantly deteriorated cardiac function, progression of TR, and right‐sided heart remodeling after 5‐year follow‐up. In a subgroup comparison of ablated patients with sinus rhythm versus AF recurrence, a PSM analysis was performed at the 5‐year follow‐up. The recurrent group showed significantly higher risks of moderate‐to‐severe TR (HR, 2.427; 95% CI, 1.261–4.671; P=0.008). AF recurrence was associated with progressive TR and significant deterioration in right‐sided heart remodeling. ConclusionsIn a retrospective PSM analysis, mitral valve disease with AF was associated with TR progression as well as right‐sided heart remodeling, which are alleviated by surgical ablation. |
| first_indexed | 2024-04-13T17:02:15Z |
| format | Article |
| id | doaj.art-6664239a12914eae9e55e9a8683c2a11 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T17:02:15Z |
| publishDate | 2016-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-6664239a12914eae9e55e9a8683c2a112022-12-22T02:38:37ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-12-0151210.1161/JAHA.116.004213Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching AnalysisJiangang Wang0Jie Han1Yan Li2Qing Ye3Fei Meng4Tiange Luo5Baiyu Tian6Haibo Zhang7Yixin Jia8Wen Zeng9Chunlei Xu10Wei Han11Yuqing Jiao12Xu Meng13Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaThe Heart Center, First Hospital of Tsinghua University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaBackgroundThis study assessed the role of surgical ablation for atrial fibrillation (AF) in decreasing tricuspid regurgitation (TR) and right‐sided heart remodeling in patients after mitral valve procedure. Methods and ResultsBetween 1994 and 2014, 1568 consecutive patients with AF undergoing mitral valve procedure were identified. In 26.0% (n=408), surgical ablation of AF was used. Propensity‐score matching (PSM) was performed on the basis of 41 known perioperative risk variables. Survival, reoperation, stroke, and moderate‐to‐severe TR, as well as echocardiography indices in long‐term follow‐up, were compared in 406 matched patient pairs (ablated and nonablated groups). The nonablated group showed significantly higher risks of death (hazard ratio [HR], 1.644; 95% CI, 1.081–2.501; P=0.020), reoperation (HR, 2.644; 95% CI, 1.299–5.466; P=0.008), and moderate‐to‐severe TR (HR, 1.436; 95% CI, 1.059–1.948; P=0.020), associated with a significantly deteriorated cardiac function, progression of TR, and right‐sided heart remodeling after 5‐year follow‐up. In a subgroup comparison of ablated patients with sinus rhythm versus AF recurrence, a PSM analysis was performed at the 5‐year follow‐up. The recurrent group showed significantly higher risks of moderate‐to‐severe TR (HR, 2.427; 95% CI, 1.261–4.671; P=0.008). AF recurrence was associated with progressive TR and significant deterioration in right‐sided heart remodeling. ConclusionsIn a retrospective PSM analysis, mitral valve disease with AF was associated with TR progression as well as right‐sided heart remodeling, which are alleviated by surgical ablation.https://www.ahajournals.org/doi/10.1161/JAHA.116.004213ablationatrial fibrillationmitral valveremodelingtricuspid regurgitation |
| spellingShingle | Jiangang Wang Jie Han Yan Li Qing Ye Fei Meng Tiange Luo Baiyu Tian Haibo Zhang Yixin Jia Wen Zeng Chunlei Xu Wei Han Yuqing Jiao Xu Meng Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease ablation atrial fibrillation mitral valve remodeling tricuspid regurgitation |
| title | Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis |
| title_full | Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis |
| title_fullStr | Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis |
| title_full_unstemmed | Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis |
| title_short | Impact of Surgical Ablation of Atrial Fibrillation on the Progression of Tricuspid Regurgitation and Right‐Sided Heart Remodeling After Mitral‐Valve Surgery: A Propensity‐Score Matching Analysis |
| title_sort | impact of surgical ablation of atrial fibrillation on the progression of tricuspid regurgitation and right sided heart remodeling after mitral valve surgery a propensity score matching analysis |
| topic | ablation atrial fibrillation mitral valve remodeling tricuspid regurgitation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004213 |
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