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Management of Atrial Fibrillation Suppression in AF-HF Comorbidity Therapy (MASCOT) Trial

  • M. G. Bongiorni
  • G. Giannola
  • G. Arena
  • E. Soldati
  • L. Padeletti
  • A. Puglisi
  • A. Curnis
  • S. Favale
  • A. Carboni
  • E. Hoffmann
  • M. Mariani
Conference paper

Abstract

Inter- [1,2], intra- [3,4], and atrioventricular [51(AV) dyssynchrony are not new concepts, but only recently have attempts been made to correct these disorders in an effort to treat heart failure (HF). A series of trials [6] has addressed partial or comprehensive cardiac resynchronization in patients with severe HF and evidence of cardiac dyssynchrony. Cardiac resynchronization should improve left ventricular (LV) performance; several trials [7-10] have demonstrated improvement in many hemodynamic parameters (LV and aortic pressure, shortening of mitral diastolic regurgitation, synchronized LV and atrial systole, LV volume, reduced myocardial oxygen consumption) and clinical end-points (quality of life, peak oxygen uptake, functional capacity, reduced number of hospitalizations). The incidence of atrial fibrillation (AF) double every 10 years in adults: there are 2-3 new cases/1000 annually in the age group of 55-64 years and 35 new cases/1000 annually between the age of 85 and 94 years [11-13]. The Framingham study demonstrated that AF is an independent risk factor for mortality with a relative risk of 1.5 for men and 1.9 for women. In patients with HF, the prevalence of AF is directly related to NYHA class: AF is present in 10% of patients in NYHA class II and 40% of patients in NYHA classes III-IV. However, HF morbidity is highly influenced by the coexistence of AF, independently of functional class. Moreover, the presence of symptomatic or asymptomatic AF in patients with LV dysfunction is linked to a poor prognosis and is independently associated with a higher risk of death from all causes and from progressive pump failure [14,15]. The prevalence of AF in most trials [16-22] on HF is shown in Fig. 1.

Keywords

Atrial Fibrillation NYHA Class Atrial Systole Asymptomatic Atrial Fibrillation Cardiac Dyssynchrony 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • M. G. Bongiorni
    • 1
  • G. Giannola
    • 2
  • G. Arena
    • 1
  • E. Soldati
    • 1
  • L. Padeletti
    • 3
  • A. Puglisi
    • 4
  • A. Curnis
    • 5
  • S. Favale
    • 6
  • A. Carboni
    • 7
  • E. Hoffmann
    • 2
  • M. Mariani
    • 1
  1. 1.Cardiothoracic DepartmentCisanello Hospital, University of PisaItaly
  2. 2.Division of CardiologyPolyclinic Hospital, University of PalermoItaly
  3. 3.Ospedale CareggiFlorenceItaly
  4. 4.Ospedale FatebenefratelliRomeItaly
  5. 5.Spedali CiviliBresciaItaly
  6. 6.Policlinico ConsorzialeBariItaly
  7. 7.Ospedale CivileParmaItaly

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