Abstract 11231: Doppler-derived Left Ventricular Negative dP/dt as a Predictor of Atrial Fibrillation or Ischemic Stroke in Patients With Degenerative Mitral Regurgitation and Normal Ejection Fraction
Introduction: The aim of this study was to investigate the role of Doppler-derived LV -dP/dt in predicting atrial fibrillation (AF) or ischemic stroke in patients with moderate to severe degenerative MR.
Methods: Doppler-derived LV -dP/dt was determined from the continuous-wave Doppler spectrum of the MR jet (-dP/dt = 32/time between 3 and 1 m/s) in 80 patients (mean age 59 ± 16 years, 41% men) with moderate to severe degenerative MR, normal LV ejection fraction (LVEF ≥ 60%), and sinus rhythm at diagnosis. Events were defined as new AF or ischemic stroke.
Results: During a mean follow-up of 18±13 months, there were 9 events (6 new AF, 3 ischemic strokes). Univariate analysis showed that older age, decreased LV -dP/dt, increased LV mass index (LVMI) and left atrial volume index (LAVI), shortened deceleration time (DT), reduced A’ velocity and elevated E/E’ ratio, prolongation of pulmonary venous (PV) atrial reversal (AR) flow duration relative to mitral inflow A wave duration (AR-Adur) were associated with events. In multivariate Cox regression analysis, Doppler-derived LV -dP/dt (for each 100mmHg/sec increase, hazard ratio: 0.165, 95% confidence interval: 0.036-0.761, p=0.021) and E/E’ (hazard ratio: 0.820, 95 % confidence interval: 0.682-0.987, p=0.036) were significant independent predictors of AF or ischemic stroke.
Conclusions: Doppler-derived LV -dP/dt is independently associated with the occurrence of AF or ischemic stroke in patients with moderate to severe degenerative MR and provides additional prognostic information.
- © 2013 by American Heart Association, Inc.