Functional Mitral Regurgitation Outcome and Grading in Heart Failure With Reduced Ejection Fraction

Quantified mitral regurgitation and left atrial function in heart failure with reduced ejection fraction: interplay and outcome implications

“…However, the extreme value of 0.40 cm 2 was rarely reached in our cohort (<2% of patients). Recently, a new threshold of severity for EROA (0.30 cm 2 ) was proposed, based on the concept of linearity to the relationship with overall mortality 16 . Our results are supportive and complementary to such threshold, as highlighted by the dismal outcome of patients with EROA ≥0.30 cm 2 (17 ± 8% CV events at 1 year and 58 ± 10% at 5 years).…”

“…EROA was the ratio of regurgitant flow to regurgitant velocity. Severe FMR was considered at an EROA ≥0.30 cm 2 according to recent evidence 16 . LAVi max was measured at ventricular end‐systole just before mitral valve opening, LAVi min was measured after atrial systole at mitral valve closure, and total LA emptying fraction was calculated as follows: [(LAVi max – LAVi min )/LAVi max ] × 100.…”

Prognostic value of myocardial work and global longitudinal strain in patients with heart failure and functional mitral regurgitation

“…The relatively small sample size may be a limitation of this single center study and a substantial number of patients did not have severe FMR. Yet, we and others previously showed that FMR is independently associated with outcome in heart failure patients [16], indicating a sufficient number of patients above threshold in this FMR cohort [32]. Additionally, we recognize that in current clinical practice, the API method does not replace the multiparametric FMR grading, as recommended by the American Society of Echocardiography and European Association of Cardiovascular Imaging.…”

“…Table 1 and Table 2 show the baseline clinical and echocardiographic characteristics of the patient population. Median PISA-EROA and PISA-RV was 0.17 [0.11-0.24] cm 2 and 29 [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] mL, respectively. Median API was 122 [87-148] arbitrary units (au).…”

“…Median API was 122 [87-148] arbitrary units (au). Median LVEF and indexed LVEDV were 35 [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] % and 84 [66-107] mL/m 2 , respectively. Mean GLS was 9.8 (± 3.43) % and median GWI was 929 [610-1276] mmHg%.…”