Significant mitral regurgitation worsens the prognosis and favors the decision of conservative treatment in octogenarians with severe symptomatic aortic stenosis.

INTRODUCTION: The coexistence of significant mitral regurgitation (MR) and severe aortic stenosis is prevalent, has a prognostic impact and makes treatment in the elderly population a complex issue. The aim of this study is to determine the prevalence of significant MR among a population of octogenarians and its influence on treatment and prognosis. METHODS: We used the data from PEGASO (Pronóstico de la Estenosis Grave Aórtica Sintomática del Octogenario), a prospective registry that consecutively included 928 patients aged ≥80 years with severe symptomatic aortic stenosis. RESULTS: The prevalence of significant MR was 8.5% (79 patients) and independently associated with the decision to treat conservatively (odds ratio = 2.28, 95% confidence interval: 1.31-3.95, p = 0.003). The group of patients with significant MR had higher overall mortality at 12 months follow-up (51.9% vs 25%, p < 0.001), which remained on division into subgroups based on the presence of comorbidities (Charlson<5: 49.2% vs 21.9%, p < 0.001; and Charlson ≥5: 62.5% vs 41.7%, p = 0.07). Within the group of patients in whom conservative treatment was performed, those with significant MR had higher mortality at one year (62.7% vs 35%, p < 0.001). MR was a significant independent predictor of overall mortality at 12-month follow-up (hazard ratio = 1.87, 95% confidence interval: 1.09-3.18, p = 0.022). CONCLUSIONS: Significant MR has a high prevalence and worsens the prognosis of octogenarian patients with severe symptomatic aortic stenosis, especially in patients with conservative treatment, independently of the existence of comorbidities.

Anomalía aislada del retorno venoso sistémico / Isolated anomaly of the systemic venous return

No disponible

Epidemiología de la fibrilación auricular / Epidemiology of atrial fibrillation

La fibrilación auricular es la arritmia cardiaca sostenida más frecuente en la población general. En España, los últimos datos indican que en mayores de 40 años la prevalencia de fibrilación auricular puede ser > 4%. La prevalencia y la incidencia de FA se han incrementado con el tiempo. Las posibles causas de este incremento son el envejecimiento de la población, el aumento de los factores de riesgo cardiovascular y la mejora de la supervivencia a enfermedades cardiovasculares. También puede influir la disponibilidad de mejores herramientas diagnósticas para su detección. Este artículo revisa los datos epidemiológicos de fibrilación auricular disponibles en España y los países occidentales (AU)

Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In Spain, the latest data suggest that the prevalence in people aged over 40 years could be greater than 4%. Both the prevalence and incidence of atrial fibrillation have increased substantially over time. Possible reasons for this rise are the aging of the population, an increase in the number of cardiovascular risk factors and better cardiovascular disease survival. In addition, the increased availability of improved diagnostic tools for detecting atrial fibrillation could have contributed. This article provides a review of the evidence available on the epidemiology of atrial fibrillation in Spain and other western countries (AU)