Comparison of clinical characteristics and prognosis of patients with atrial functional mitral regurgitation exhibiting sinus rhythm and atrial fibrillation.

This article focuses on atrial functional mitral regurgitation (AFMR), a form of mitral valve dysfunction occurring without left ventricular impairment, and compares clinical characteristics and outcomes among patients with AFMR in sinus rhythm (AFMRSR), paroxysmal atrial fibrillation (AFMRpAF), and non-paroxysmal atrial fibrillation (AFMRnon-pAF). The study analyzed 1007 patients, finding distinct echocardiographic and clinical profiles between AFMRSR and AFMRnon-pAF groups, suggesting different underlying mechanisms such as left ventricular diastolic dysfunction and concomitant valvular disease in AFMRSR. Despite these differences, the rates of adverse events, including all-cause death and heart failure hospitalization, were similarly high across all rhythm groups over a median follow-up of nearly three years. The findings highlight the need for careful management of AFMR patients regardless of cardiac rhythm, as treatment strategies and prognoses vary but event rates remain significant.