TY - JOUR T1 - Prognosis of patients with secondary mitral regurgitation and reduced ejection fraction JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2017-000745 VL - 5 IS - 1 SP - e000745 AU - Samer Mowakeaa AU - Aeshita Dwivedi AU - Jason R Grossman AU - Gaurav Parikh AU - Zelmira Curillova AU - Krishna G Aragam AU - Sammy Elmariah AU - Scott Kinlay AU - Jayashri Aragam Y1 - 2018/01/01 UR - http://openheart.bmj.com/content/5/1/e000745.abstract N2 - Objective The impact of the severity of secondary mitral regurgitation (MR) on the risk of death and heart failure (HF) hospitalisations in patients with reduced left ventricular (LV) systolic function is poorly defined. The study sought to identify the incremental risk of secondary MR in patients with reduced LV systolic function.Methods We studied 615 consecutive patients with LV ejection fraction ≤35% by transthoracic echocardiography at a single medical centre. Patients were divided into three groups of no MR, mild, or moderate to severe MR. The median follow-up was 2.9 years. The primary endpoint was a composite of death or HF hospitalisations.Results Compared with patients with no MR, the risk of death or HF hospitalisations was higher for mild MR (HR 1.7, P=0.003) and moderate to severe MR (HR 2.7, P<0.001). The risk was also higher for the component endpoints of HF hospitalisations (mild MR: HR 2.3, P=0.001; moderate to severe MR: HR 3.5, P<0.001) and death (mild MR: HR 1.6, P=0.033; moderate to severe MR: HR 2.6, P<0.001). After adjustment for other covariates, MR was no longer significantly associated with death or HF hospitalisations, or death alone, but remained significantly associated with HF hospitalisations (mild MR: HR 1.7, P=0.028; moderate to severe MR: HR 2.2, P=0.002).Conclusions In patients with reduced LV systolic function, secondary MR is associated with an increased risk of HF hospitalisations but not death. ER -