Objective

Some hyperacute stroke patients have unfavorable outcomes after endovascular thrombectomy (EVT) despite successful recanalization. We hypothesized that a cardiac parameter, moderate-to-severe mitral regurgitation (MR), might decrease the rate of favorable clinical outcome after EVT in patients with atrial fibrillation (AF).

Method

From our prospective EVT registry, AF patients who underwent transthoracic echocardiography (TTE) were retrospectively analyzed. Based on the presence of moderate-to-severe MR, patients were assigned to either significant MR or nonsignificant MR group. The severity of MR was determined by the ratio of the color Doppler jet area to the left atrial area in mid-systole. Moderate-to-severe MR was estimated to be at a ratio of >20%. Favorable outcome was defined as having a modified Rankin Scale score of 0–1 at 3 months.

Result

127 patients with AF who underwent TTE were included in the study. TTE results found that 25 (20%) patients had significant MR. Patients with significant MR were older (p = 0.051) and had enlarged left (p = 0.015) and right (p = 0.002) atria. Tricuspid and aortic regurgitation (p = 0.007 and 0.043, respectively) were more severe in significant MR group. At 3 months, favorable outcomes were 11% in the significant MR group and 26% in the non-significant MR group (p = 0.031). Multivariate regression analysis reported that moderate-to-severe MR was a negative predictor of favorable outcome (odds ratio = 0.14; 95% confidence interval = 0.02, 0.84; p = 0.031).

Conclusions

Significant MR might prevent the clinical recovery of AF patients.

中文翻译：

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脑卒中患者血管内血栓切除术后二尖瓣反流与临床预后之间的关联。

目的

尽管重新通气成功，但一些超急性中风患者在血管内血栓切除术（EVT）后仍具有不良的预后。我们假设心脏参数，中度至重度二尖瓣关闭不全（MR），可能会降低房颤（AF）患者EVT后的临床预后良好率。

方法

从我们的前瞻性EVT注册表中，回顾性分析了经胸超声心动图（TTE）的房颤患者。根据中度至重度MR的存在，将患者分为显着MR组或非显着MR组。MR的严重程度由彩色多普勒射流面积与心脏收缩中期左心房面积之比确定。中度至重度MR的比例估计> 20％。良好的结局定义为在3个月时改良的Rankin量表评分为0-1。

结果

127名患有TTE的房颤患者被纳入研究。TTE结果发现25名（20％）患者患有明显的MR。MR较高的患者年龄较大（p = 0.051），左心房增大（p = 0.015），右心房增大（p = 0.002）。三尖瓣和主动脉瓣关闭不全（分别为p = 0.007和0.043）在明显的MR组中更为严重。在3个月时，显着MR组的有利结果为11％，非显着MR组为26％（p = 0.031）。多元回归分析表明，中度至重度MR是不良预后的阴性预测因子（几率= 0.14； 95％置信区间= 0.02、0.84； p = 0.031）。

结论

严重的MR可能会阻止AF患者的临床康复。