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Relationship of functional mitral regurgitation to new-onset atrial fibrillation in acute myocardial infarction Fadel Bahouth, Diab Mutlak, Moran Furman, et al. Heart 2010 96: 683-688
doi: 10.1136/hrt.2009.183822
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Downloaded from heart.bmj.com on May 1, 2010 - Published by group.bmj.com
Heart rhythm disorders
Relationship of functional mitral regurgitation to new-onset atrial fibrillation in acute myocardial infarction Fadel Bahouth,1,2 Diab Mutlak,1,2 Moran Furman,1,2 Anees Musallam,1,2 Haim Hammerman,1,2 Jonathan Lessick,1,2 Saleem Dabbah,1,2 Shimon Reisner,1,2 Yoram Agmon,1,2 Doron Aronson1,2 1 Department of Cardiology, Rambam Medical Center, Haifa, Israel 2 The Rappaport Faculty of Medicine and Research Institute, Technion, Israel Institute of Technology, Bat Galim, Haifa 31096 Israel
Correspondence to Dr Doron Aronson, Department of Cardiology, Rambam Medical Center, Bat Galim, POB 9602, Haifa 31096, Israel;
[email protected] Accepted 21 December 2009
ABSTRACT Background/objective The role of factors that increase left atrial pressure or cause acute left atrial dilatation is frequently emphasised in the pathogenesis of atrial fibrillation (AF) in patients with acute myocardial infarction (AMI). This study was designed to test the hypothesis that functional mitral regurgitation (FMR) occurring after AMI may promote AF by producing left atrial volume overload. Setting Intensive care unit of a tertiary care hospital. Patients and Methods 1920 patients admitted with AMI were studied. Patients with known AF were excluded. FMR was classified using echocardiography into three groups: none; mild FMR and moderate or severe FMR. The relationship between FMR and AF occurring at any time during the hospital course was examined using multivariable logistic regression. Results Mild FMR was present in 744 patients (38.8%) and moderate or severe FMR was present in 150 patients (7.8%). AF developed in 51 (5.0%), 83 (11.2%) and 28 (18.7%) patients with no FMR, mild FMR and moderate or severe FMR, respectively (p trend
