Hang Xu, Xinhe Xu, Jiexu Ma, Shanshan Zheng, Wu Song, Zhaoji Zhong, Sheng Liu
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Additionally, subgroup analyses were conducted to evaluate the predictive value of preoperative parameters for the development of acute POAF.</p><p><strong>Results: </strong>Acute POAF was observed in 152 patients (13.5%). After adjusting for covariates, multivariate analysis revealed that age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.03-1.07, <i>p</i> < 0.001), hypertension (OR 1.50; 95% CI 1.03-2.21, <i>p</i> = 0.037), left ventricular ejection fraction (OR 0.95; 95% CI 0.92-0.98, <i>p</i> = 0.004), and left atrial enlargement (OR 1.03; 95% CI 1.00-1.06, <i>p</i> = 0.019) were independent predictors of acute POAF. The interventricular septum (IVS) thickness demonstrated a strong association with acute POAF (OR 1.21; 95% CI 1.06-1.38, <i>p</i> = 0.005). The optimal cut-off value for the IVS thickness in predicting acute POAF was 11.0 mm. The adjusted OR of association between an IVS thickness >11 mm and acute POAF was 1.73 (95% CI 1.03-2.89, <i>p</i> = 0.037). The IVS thickness was consistently identified as a significant predictor of POAF in the subgroup analyses.</p><p><strong>Conclusions: </strong>Preoperative assessment of clinical morbidity and echocardiographic parameters, particularly IVS thickness, can be valuable in identifying high-risk patients for acute POAF and informing targeted strategies for prevention and management.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38938"},"PeriodicalIF":1.3000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415746/pdf/","citationCount":"0","resultStr":"{\"title\":\"Preoperative Risk Factors for Acute Postoperative Atrial Fibrillation in Patients Undergoing Mitral Valve Repair for Degenerative Mitral Regurgitation: Insights Into Cardiac Geometry.\",\"authors\":\"Hang Xu, Xinhe Xu, Jiexu Ma, Shanshan Zheng, Wu Song, Zhaoji Zhong, Sheng Liu\",\"doi\":\"10.31083/RCM38938\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) commonly occurs following surgical repair of degenerative mitral regurgitation (DMR) and is associated with unfavorable outcomes. This study aimed to identify preoperative risk factors for acute POAF in patients undergoing mitral valve repair for DMR, with a specific focus on the role of preoperative echocardiography.</p><p><strong>Methods: </strong>A retrospective study was conducted involving 1127 DMR patients who underwent mitral valve repair between 2017 and 2022. The primary endpoint was the occurrence of acute POAF within 30 days after surgery. Univariate and multivariate logistic regression analyses were performed to identify risk factors for POAF. Additionally, subgroup analyses were conducted to evaluate the predictive value of preoperative parameters for the development of acute POAF.</p><p><strong>Results: </strong>Acute POAF was observed in 152 patients (13.5%). After adjusting for covariates, multivariate analysis revealed that age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.03-1.07, <i>p</i> < 0.001), hypertension (OR 1.50; 95% CI 1.03-2.21, <i>p</i> = 0.037), left ventricular ejection fraction (OR 0.95; 95% CI 0.92-0.98, <i>p</i> = 0.004), and left atrial enlargement (OR 1.03; 95% CI 1.00-1.06, <i>p</i> = 0.019) were independent predictors of acute POAF. The interventricular septum (IVS) thickness demonstrated a strong association with acute POAF (OR 1.21; 95% CI 1.06-1.38, <i>p</i> = 0.005). The optimal cut-off value for the IVS thickness in predicting acute POAF was 11.0 mm. The adjusted OR of association between an IVS thickness >11 mm and acute POAF was 1.73 (95% CI 1.03-2.89, <i>p</i> = 0.037). 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引用次数: 0
摘要
背景：术后心房颤动（POAF）通常发生在退行性二尖瓣返流（DMR）手术修复后，并与不良预后相关。本研究旨在确定二尖瓣修复DMR患者急性POAF的术前危险因素，并特别关注术前超声心动图的作用。方法：对2017年至2022年间接受二尖瓣修复的1127例DMR患者进行回顾性研究。主要终点是术后30天内急性POAF的发生。进行单因素和多因素logistic回归分析以确定POAF的危险因素。此外，进行亚组分析以评估术前参数对急性POAF发展的预测价值。结果：急性POAF 152例（13.5%）。调整协变量后，多变量分析显示年龄(优势比（OR） 1.05；95%可信区间（CI） 1.03-1.07, p < 0.001)、高血压（OR 1.50; 95% CI 1.03-2.21, p = 0.037）、左室射血分数（OR 0.95; 95% CI 0.92-0.98, p = 0.004）和左房扩大（OR 1.03; 95% CI 1.00-1.06, p = 0.019）是急性POAF的独立预测因子。室间隔（IVS）厚度与急性POAF密切相关（OR 1.21; 95% CI 1.06-1.38, p = 0.005）。IVS厚度预测急性POAF的最佳临界值为11.0 mm。IVS厚度bbb11 mm与急性POAF的校正OR为1.73 （95% CI 1.03-2.89, p = 0.037）。在亚组分析中，IVS厚度一直被认为是POAF的重要预测因子。结论：术前评估临床发病率和超声心动图参数，特别是IVS厚度，对于识别急性POAF的高危患者和提供有针对性的预防和治疗策略具有重要价值。
Preoperative Risk Factors for Acute Postoperative Atrial Fibrillation in Patients Undergoing Mitral Valve Repair for Degenerative Mitral Regurgitation: Insights Into Cardiac Geometry.
Background: Postoperative atrial fibrillation (POAF) commonly occurs following surgical repair of degenerative mitral regurgitation (DMR) and is associated with unfavorable outcomes. This study aimed to identify preoperative risk factors for acute POAF in patients undergoing mitral valve repair for DMR, with a specific focus on the role of preoperative echocardiography.
Methods: A retrospective study was conducted involving 1127 DMR patients who underwent mitral valve repair between 2017 and 2022. The primary endpoint was the occurrence of acute POAF within 30 days after surgery. Univariate and multivariate logistic regression analyses were performed to identify risk factors for POAF. Additionally, subgroup analyses were conducted to evaluate the predictive value of preoperative parameters for the development of acute POAF.
Results: Acute POAF was observed in 152 patients (13.5%). After adjusting for covariates, multivariate analysis revealed that age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.03-1.07, p < 0.001), hypertension (OR 1.50; 95% CI 1.03-2.21, p = 0.037), left ventricular ejection fraction (OR 0.95; 95% CI 0.92-0.98, p = 0.004), and left atrial enlargement (OR 1.03; 95% CI 1.00-1.06, p = 0.019) were independent predictors of acute POAF. The interventricular septum (IVS) thickness demonstrated a strong association with acute POAF (OR 1.21; 95% CI 1.06-1.38, p = 0.005). The optimal cut-off value for the IVS thickness in predicting acute POAF was 11.0 mm. The adjusted OR of association between an IVS thickness >11 mm and acute POAF was 1.73 (95% CI 1.03-2.89, p = 0.037). The IVS thickness was consistently identified as a significant predictor of POAF in the subgroup analyses.
Conclusions: Preoperative assessment of clinical morbidity and echocardiographic parameters, particularly IVS thickness, can be valuable in identifying high-risk patients for acute POAF and informing targeted strategies for prevention and management.
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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