{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:34:44Z","timestamp":1793151284780,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atrial functional mitral regurgitation (AFMR) has been associated with atrial fibrillation (AF) and heart failure with preserved ejection fraction. However, data on incident AFMR are scarce. We aimed to study the incidence, risk factors, and clinical significance of AFMR in AF or sinus rhythm (SR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Adults with new diagnosis of AF and adults in SR were identified. Patients with &amp;gt;mild MR at baseline, primary mitral disease, cardiomyopathy, left-sided valve disease, previous cardiac surgery, or with no follow-up echocardiogram were excluded. Diastolic dysfunction (DD) was indicated by \u22652\/4 abnormal diastolic function parameters [mitral medial e\u2032, mitral medial E\/e\u2032, tricuspid regurgitation velocity, left atrial volume index (LAVI)]. Overall, 1747 patients with AF and 29 623 in SR were included. Incidence rate of &amp;gt;mild AFMR was 2.6 per 100 person-year in new-onset AF and 0.7 per 100 person-year in SR, P &amp;lt; 0.001. AF remained associated with AFMR in a propensity score-matched analysis based on age, sex, and comorbidities between AF and SR [hazard ratio: 3.80 (95% confidence interval 3.04\u20134.76)]. Independent risk factors associated with incident AFMR were age \u226565 years, female sex, LAVI, and DD in both AF and SR, in addition to rate (vs. rhythm) control in AF. Incident AFMR was independently associated with all-cause death in both groups (both P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AF conferred a three-fold increase in the risk of incident AFMR. DD, older age, left atrial size, and female sex were independent risk factors in both SR and AF, while rhythm control was protective. AFMR was universally associated with worse mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jead199","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T13:06:20Z","timestamp":1691586380000},"page":"1450-1457","source":"Crossref","is-referenced-by-count":48,"title":["Incidence, risk factors, and outcomes of atrial functional mitral regurgitation in patients with atrial fibrillation or sinus rhythm"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6210-7669","authenticated-orcid":false,"given":"Jwan A","family":"Naser","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector I","family":"Michelena","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1340-0647","authenticated-orcid":false,"given":"Christopher G","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic , Rochester, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunjung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8237-4422","authenticated-orcid":false,"given":"Austin M","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic , Rochester, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4308-0456","authenticated-orcid":false,"given":"Peter A","family":"Noseworthy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-3521","authenticated-orcid":false,"given":"Patricia A","family":"Pellikka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6095-5579","authenticated-orcid":false,"given":"Vuyisile T","family":"Nkomo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5256-3150","authenticated-orcid":false,"given":"Sorin V","family":"Pislaru","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , 200 First Street SW, Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"2023102807051457700_jead199-B1","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/j.jacc.2015.02.009","article-title":"Secondary mitral regurgitation in heart failure: pathophysiology, prognosis, and therapeutic considerations","volume":"65","author":"Asgar","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2023102807051457700_jead199-B2","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1016\/j.jcmg.2021.05.017","article-title":"Functional mitral regurgitation outcome and grading in heart failure with reduced ejection fraction","volume":"14","author":"Benfari","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023102807051457700_jead199-B3","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1136\/hrt.2011.225789","article-title":"Independent prognostic value of functional mitral regurgitation in patients with heart failure. 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