{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T04:07:30Z","timestamp":1754194050253},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T00:00:00Z","timestamp":1631923200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T00:00:00Z","timestamp":1631923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Valvular heart disease (VHD) in non-valvular atrial fibrillation (AF) is a puzzling clinical entity. The aim of this study was to evaluate the prognostic effect of significant VHD (sVHD) among patients with non-valvular AF.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a post-hoc analysis of the MISOAC-AF trial (NCT02941978). Consecutive inpatients with non-valvular AF who underwent echocardiography were included. sVHD was defined as the presence of at least moderate aortic stenosis (AS) or aortic\/mitral\/tricuspid regurgitation (AR\/MR\/TR). Cox regression analyses with covariate adjustments were used for outcome prediction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 983 patients with non-valvular AF (median age 76 [14] years) were analyzed over a median follow-up period of 32 [20] months. sVHD was diagnosed in 575 (58.5%) AF patients. sVHD was associated with all-cause mortality (21.6%\/yr vs. 6.5%\/yr; adjusted HR [aHR] 1.55, 95% confidence interval [CI] 1.17\u20132.06; <jats:italic>p<\/jats:italic>\u2009=\u20090.02), cardiovascular mortality (16%\/yr vs. 4%\/yr; aHR\u00a01.70, 95% CI 1.09\u20132.66; <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and heart failure-hospitalization (5.8%\/yr vs. 1.8%\/yr; aHR 2.53, 95% CI 1.35\u20134.63; <jats:italic>p<\/jats:italic>\u2009=\u20090.02). The prognostic effect of sVHD was particularly evident in patients aged\u2009&lt;\u200980\u00a0years and in those without history of heart failure (<jats:italic>p<\/jats:italic> for interaction\u2009&lt;\u20090.05, in both subgroups). After multivariable adjustment, moderate\/severe AS and TR were associated with mortality, while AS and MR with heart failure-hospitalization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Among patients with non-valvular AF, sVHD was highly prevalent and beared high prognostic value across a wide spectrum of clinical outcomes, especially in patients aged\u2009&lt;\u200980\u00a0years or in the absence of heart failure. Predominantly AS, as well as MR and TR, were associated with worse prognosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12872-021-02264-3","type":"journal-article","created":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T06:02:49Z","timestamp":1631944969000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic implications of valvular heart disease in patients with non-valvular atrial fibrillation"],"prefix":"10.1186","volume":"21","author":[{"given":"Athanasios","family":"Samaras","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Vrana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios","family":"Kartas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios V.","family":"Moysidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas S.","family":"Papazoglou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Doundoulakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Fotos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Rampidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios G.","family":"Tsalikakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Efthimiadis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haralambos","family":"Karvounis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Apostolos","family":"Tzikas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Giannakoulas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,9,18]]},"reference":[{"issue":"8","key":"2264_CR1","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1161\/CIRCULATIONAHA.113.005119","volume":"129","author":"SS Chugh","year":"2014","unstructured":"Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. 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