Atrial Functional MR -- It's Not the Same as Ventricular Functional MR

Background: Atrial functional mitral regurgitation (AFMR) is related to mitral annular dilation and left atrial (LA) enlargement. Risk factors include age, female gender, atrial fibrillation (AF), and diastolic dysfunction. It is associated with increased mortality. Objective: To assess the incidence of new-onset left ventricle (LV) systolic dysfunction (LVSD) in AFMR, rates of progression or regression of AFMR and associated echocardiographic changes, and impact of progression or regression on mortality. Participants/Methods: 635 consecutive adults with LA volume index (LAVI) of ≥40 mL/m 2 and ≥mild to moderate mitral regurgitation (MR) were included. Those with dilated LV ejection fraction (LVEF) of <50%, regional wall motion abnormalities, or valvular disease were excluded. The study group was compared to patients with LAVI of ≥40 mL/m 2 and no or mild AFMR. AFMR patients had a dilated mitral annulus (systolic anteroposterior diameter of ≥35 mm). LA emptying fraction (LAEF) was more...