Regular paperRelation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure
Section snippets
Patient selection
We prospectively analyzed collected data from the Duke Cardiovascular Databank on patients who underwent diagnostic cardiac catheterization in the adult catheterization laboratory at Duke University Medical Center for the evaluation of clinical heart failure (New York Heart Association [NYHA] class II to IV). Patients with a LV ejection fraction <40% were included in this analysis, and those with the following clinical characteristics were excluded: myocardial infarction within 30 days of
Frequency of MR
Two thousand and fifty-seven patients met the study criteria between January 1, 1986, and December 31, 2000 (Figure 1). Median follow-up of patients in the cohort was 3.4 years (1.4, 7.1). Of the total population, 1,156 of 2,057 subjects had MR of any grade (56.2%). Of these patients, 811 (70.1%) had mild (grades 1+ or 2+) and 345 (29.8%) had moderate or severe (grades 3+ or 4+) regurgitation.
Baseline characteristics
Table 1lists baseline characteristics for patients included in this analysis. Patients in our cohort
Discussion
Our study represents the largest analysis to date that examines the frequency of MR in patients with LV systolic dysfunction and heart failure and its effect on survival. These data demonstrate that MR, as identified by ventriculography, is very common in this population; almost 60% of these patients have MR of any grade. Most patients in whom MR was identified had a mild (grade 1+ or 2+) degree of regurgitation. In the unadjusted analysis, patients with MR of any grade had significantly worse
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