TY - JOUR T1 - Echo-Doppler determinants of outcomes in patients with unoperated significant mitral regurgitation in current era JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2015-000378 VL - 3 IS - 2 SP - e000378 AU - Asim M Rafique AU - Parham Zarrini AU - Nirmal Singh AU - Roy Beigel AU - Rigved Tadwalkar AU - Meshe Chonde AU - Leandro Slipczuk AU - Bojan Cercek AU - Saibal Kar AU - Robert J Siegel Y1 - 2016/07/01 UR - http://openheart.bmj.com/content/3/2/e000378.abstract N2 - Objective One-half of patients with severe symptomatic mitral regurgitation (MR) do not undergo surgery due to comorbidities. We evaluated prognosticators of outcomes in patients with unoperated significant MR.Methods In this observational study, we retrospectively evaluated medical records of 75 consecutive patients with unoperated significant MR.Results All-cause mortality was 39% at 5 years. Non-survivors (n=29) versus survivors (n=46) were: older (77±9.8 vs 68±14, p=0.006), had higher New York Heart Association (NYHA) class (2.7±0.8 vs 2.3±0.8, p=0.037), higher brain natriuretic peptide (1157±717 vs 427±502 pg/mL, p=0.024, n=18), more coronary artery disease (61% vs 35%, p=0.031), more frequent left ventricular ejection fraction <50% (20.7% vs 4.3%, p=0.026), more functional MR (41% vs 22%, p=0.069), higher mitral E/E′ (12.7±4.6 vs 9.8±4, p=0.008), higher pulmonary artery systolic pressure (PASP; 52.6±18.7 vs 36.7±14, p <0.001), more ≥3+ tricuspid regurgitation (28% vs 4%, p=0.005) and more right ventricular dysfunction (26% vs 6%, p=0.035). Significant predictors of 5-year mortality were PASP (p=0.001) and E/E′ (p=0.011) using multivariate regression analysis.Conclusions Patients with unoperated significant MR have high mortality. Elevated PASP and mitral E/E′ were the most significant predictors of 5-year survival in patients with unoperated significant MR. Current American College of Cardiology (ACC)/American Heart Association (AHA) guidelines provide a limited incorporation of echo-Doppler parameters in the preoperative risk stratification of patients with severe MR. ER -