Looking into the Mechanistic Link Between Mitral Regurgitation and Atrial Fibrillation

Yukio Abe; Yosuke Takahashi; Toshihiko Shibata

doi:10.1016/j.ccl.2021.01.010

Looking into the Mechanistic Link Between Mitral Regurgitation and Atrial Fibrillation

Cardiol Clin. 2021 May;39(2):281-288. doi: 10.1016/j.ccl.2021.01.010. Epub 2021 Mar 23.

Authors

Yukio Abe¹, Yosuke Takahashi², Toshihiko Shibata²

Affiliations

¹ Department of Cardiology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka 534-0021, Japan. Electronic address: abeyukio@aol.com.
² Department of Cardiovascular Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.

PMID: 33894941
DOI: 10.1016/j.ccl.2021.01.010

Abstract

Atrial functional mitral regurgitation (AFMR) can occur in patients with atrial fibrillation despite a preserved left ventricular systolic function. AFMR has received attention as a cause of heart failure; it is a therapeutic target in patients with heart failure with atrial fibrillation. Mitral annular dilatation from atrial fibrillation-induced left atrial dilatation is necessary for the generation of AFMR. Posterior mitral leaflet hamstringing also relates to the generation of AFMR. Further mitral annular dilatation owing to progressive left atrial and left ventricular dilatations, with mitral regurgitation-induced volume overload, worsens AFMR.

Keywords: Atrial fibrillation; Atrial functional mitral regurgitation; Echocardiography; Heart failure; Valvular heart disease.

Publication types

Review

MeSH terms

Atrial Fibrillation* / complications
Atrial Fibrillation* / epidemiology
Heart Atria
Humans
Mitral Valve / diagnostic imaging
Mitral Valve Insufficiency* / etiology
Ventricular Function, Left