The clinical course of patients with severe “rheumatic” mitral insufficiency

Ellis, Laurence B.; Ramirez, Alberto

doi:10.1016/0002-8703(69)90047-7

Cited by 23 publications

(3 citation statements)

References 18 publications

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“…Generally it has been well described that the prevalence of AF doubles with each advancing decade of age, from 0.5% at age 50-59 years to almost 9% at age 80-89 years [23]. AF patients had more often history of congestive heart failure and valvular heart disease, this is in agreement with most earlier reports [19,24,25]. Heart failure may contribute to the pathogenesis of atrial fibrillation, with electromechanical feedback and neurohumoral activation playing an important mediating role [26].…”

Section: Factors Associated With Afsupporting

confidence: 88%

Clinical Profile and Angiographic Findings among Patients with Atrial Fibrillation Presenting for Selective Coronary Angiography

Chowdhury¹

2013

Angiol

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Section: Factors Associated With Afsupporting

confidence: 88%

Clinical Profile and Angiographic Findings among Patients with Atrial Fibrillation Presenting for Selective Coronary Angiography

Chowdhury¹

2013

Angiol

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“…Generally it has been well described that the prevalence of AF doubles with each advancing decade of age, from 0.5% at age 50 -59 years to almost 9% at age 80 -89 years [23]. AF patients had more often history of congestive heart failure and valvular heart disease, this is in agreement with most earlierreports [19,24,25]. Heart failure may contribute to the pathogenesis of atrial fibrillation, with electromechanical feedback and neurohumoral activation playing an important mediating role [26].…”

Section: Factors Associated With Afsupporting

confidence: 83%

Clinical profile and angiographic findings among patients with atrial fibrillation presenting for selective coronary angiography

Elabbassi¹,

Chowdhury²,

Líska³

et al. 2014

Health

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Background: Coronary artery disease is the most common form of cardiovascular disease while Atrial fibrillation is the most common sustained arrhythmia. We set out to investigate the prevalence and clinical profile of patients with atrial fibrillation who present for selective coronary angiography and whether this has an effect on the angiogram findings and the treatment options offered to them. Methods and Results: This was a retrospectively collected database of 494 patients presenting for SCAG from 01.11.2010 to 30.11.2010 and 01.04.2010 to 30.04.2010. We collected and analyzed clinical characteristics of patients, their SCAG finding and modes of treatment offered up to discharge. 24.6% of patients had AF. They tended to be older, more commonly women, current or ex-smokers; presented with symptoms of atypical chest pain and were more likely to have a history of congestive heart failure or valvular heart disease. They had a longer hospital stay. Using CHADS-Vasc score, 83.6% were moderate to high risk for CVA. At SCAG, they were more likely to have non-significant coronary artery disease, and hence were more likely to be treated conservatively. Conclusion: AF patients presenting for SCAG constitute a unique subset of patients who despite having a higher likelihood of non-significant coronary stenosis are still prone to suffering from poorly-understood and under-appreciated myo-cardial ischemia.

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“…Some older, pre-echocardiographic studies on rheumatic heart disease in Western populations demonstrated variable natural histories, ranging from CRMR being a benign lesion with a normal life expectancy, to it being a severe, progressive and ultimately fatal disease. 31 - 33 Natural history studies in degenerative MR, with follow up ranging from seven months to 10 years, have shown increased risk of sudden cardiac death and increased postoperative morbidity and mortality rates in the presence of severe MR symptoms, arrhythmias, left ventricular end-systolic dimensions (LVESD) ≥ 45 mm and ejection fraction (EF) ≤ 60%. 8 , R34 - 39 These studies, primarily pertaining to degenerative, significant MR, evaluated symptomatic and asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

Is there a role for combination anti-remodelling therapy for heart failure secondary to chronic rheumatic mitral regurgitation?

Meel

Peters

Libhaber

et al. 2017

CVJA

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SummaryIntroduction:The value of combination anti-remodelling therapy for heart failure (HF) secondary to mitral regurgitation (MR) is unknown. We studied the effect of anti-remodelling therapy on clinical and echocardiographic parameters in patients with severe chronic rheumatic mitral regurgitation (CRMR) presenting in HF.Methods:Thirty-one patients (29 females) at Chris Hani Baragwanath Academic Hospital, treated with combination therapy for HF due to CRMR and New York Heart Association functional class II–III symptoms, underwent prospective six-month follow up.Results:Mean age was 50.7 ± 8.5 years. No patients died or were hospitalised for HF during the study period. No worsening of clinical symptoms or functional status, or left and right ventricular echocardiographic parameters (p > 0.05) was noted. Peak left atrial systolic strain improved at six months (18.7 ± 7.7 vs 23.6 ± 8.5%, p = 0.02).Conclusion:This preliminary analysis suggests that combination anti-remodelling therapy may be beneficial for HF secondary to CRMR. We had no HF-related admissions or deaths, and no deterioration in echocardiographic parameters of ventricular size and function.

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The clinical course of patients with severe “rheumatic” mitral insufficiency

Cited by 23 publications

References 18 publications

Clinical Profile and Angiographic Findings among Patients with Atrial Fibrillation Presenting for Selective Coronary Angiography

Clinical Profile and Angiographic Findings among Patients with Atrial Fibrillation Presenting for Selective Coronary Angiography

Clinical profile and angiographic findings among patients with atrial fibrillation presenting for selective coronary angiography

Is there a role for combination anti-remodelling therapy for heart failure secondary to chronic rheumatic mitral regurgitation?

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