Document Detail

Prognostic importance of a restrictive transmitral filling pattern in patients with symptomatic congestive heart failure and atrial fibrillation.
MedLine Citation:
PMID:  19958865     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Restrictive diastolic filling pattern is associated with increased mortality in patients with myocardial infarction and heart failure. Most studies have excluded patients with atrial fibrillation. The aim of the present study was to assess the prognostic value of a restrictive filling pattern in patients with atrial fibrillation. METHODS: Doppler echocardiography including pulsed wave Doppler assessment of transmitral flow was performed in 880 patients with a clinical diagnosis of heart failure on hospital admission. Filling was considered restrictive when the mitral deceleration time <or=140 milliseconds. RESULTS: On admission, 337 (39%) of the patients had atrial fibrillation. Among patients in atrial fibrillation, 170 (50%) had a restrictive filling; and in patients in sinus rhythm, 256 (47%) had restrictive filling (P = .34). During follow-up of median 6.7 years (range 5.3-7.8), 564 patients died (64%). Mortality was significantly higher in patients with a restrictive filling pattern irrespective of atrial fibrillation or sinus rhythm (P < .001). In a multivariable model only including patients in atrial fibrillation, a restrictive filling pattern remained a significant predictor of all-cause mortality (hazard ratio 1.79, 95% CI 1.24-2.58, P =.002). CONCLUSIONS: In a heterogeneous population hospitalized for symptomatic heart failure, a restrictive transmitral filling pattern during hospitalization is an ominous prognostic sign also in patients presenting with atrial fibrillation.
Jakob Rauns??; Jacob Eifer M??ller; Jesper Kjaergaard; Dilek Akkan; Christian Hassager; Christian Torp-Pedersen; Lars K??ber;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  158     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-04     Completed Date:  2010-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  983-8     Citation Subset:  AIM; IM    
Department of Cardiology, Copenhagen University Hospital, Gentofte Hospital, Copenhagen, Denmark.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / complications,  mortality*,  physiopathology*
Heart Failure / complications,  mortality*,  physiopathology*
Middle Aged
Mitral Valve / physiopathology*

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