Cardiology Letters 2021, 30(3):201-206

From HFpEF and atrial fibrillation to severe functional mitral regurgitation

Vysočanský S, Postulka J, Líška B, Dlesk A, Goncalvesová E

Kardiologická klinika Lekárská fakulta UK a Národný ústav srdcových a cievnych chorôb, a. s., Bratislava, Slovenská republika

Atrial functional mitral regurgitation (AFMR) represents a type of mitral regurgitation (MR) which has not been described in detail so far and is present typically in patients with prolonged history of atrial fibrillation (AF) and/or heart failure with preserved ejection fraction (HFpEF). Considering the aging of the population, we can expect such patients in our clinical practice more often. Progress in 3D transesophageal echocardiography allowed the study and description of mechanisms which are crucial for developing AFMR. Treatment options are limited, focused on left atrial remodelling either pharmacologically or by interventional arrythmology methods. Surgery is recommended in severe AFMR. We present the case of a 74-year-old patient with paroxysmal atrial fibrillation, repeatedly admitted to hospital for dyspnea due to HFpEF. During the first hospitalization, mild MR was present. During the following 10 years she was decompensated numerous times. During a second hospitalization in our department persistent atrial fibrillation, severe MR, dilatation of left atrium and mitral anullus were present. Considering the clinical symptoms, and that no other therapeutical options were left, surgery was indicated.

Keywords: mitral regurgitation; atrial fibrillation; heart failure with preserved ejection fraction

Published: March 1, 2021  Show citation