RT Journal Article
SR Electronic
T1 Prognosis of patients with secondary mitral regurgitation and reduced ejection fraction
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000745
DO 10.1136/openhrt-2017-000745
VO 5
IS 1
A1 Samer Mowakeaa
A1 Aeshita Dwivedi
A1 Jason R Grossman
A1 Gaurav Parikh
A1 Zelmira Curillova
A1 Krishna G Aragam
A1 Sammy Elmariah
A1 Scott Kinlay
A1 Jayashri Aragam
YR 2018
UL http://openheart.bmj.com/content/5/1/e000745.abstract
AB 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.