Overview of mitral regurgitation in Europe: results from the European Registry of mitral regurgitation (EuMiClip)

Ruiz, Juan Manuel Monteagudo; Galderisi, Maurizio; Buonauro, Agostino; Badano, Luigi P.; Aruta, Patrizia; Swaans, Martin J.; Sanchís, Laura; Saraste, Antti; Monaghan, Mark; Θεοδωρόπουλος, Κωνσταντίνος; Papitsas, Michael; Liel‐Cohen, Noah; Kobal, Sergio; Bervar, M; Berlot, B; Filippatos, Gerasimos; Ikonomidis, Ignatios; Katsanos, Spyridon; Tanner, Felix C.; Cassani, Daniela; Faletra, Francesco F.; Leo, Laura Anna; Martinez, A.; Matabuena, Javier; Grande‐Trillo, Antonio; Alonso-Rodríguez, David; Mesa, Dolores; González‐Alujas, Teresa; Sitges, Marta; Carrasco-Chinchilla, Fernando; Li, Chi-Hion; Fernández-Golfín, Covadonga; Zamorano, José Luís

doi:10.1093/ehjci/jey011

Cited by 45 publications

(22 citation statements)

References 14 publications

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“…Studies from Southwest Ethiopia, 12 Madrid, Spain, 22 and 19 European centers 23 revealed that RHD was significantly higher in females when compared to males. Similarly, the current study indicated a high rate of RHD among females (35%) when compared to males (16.4%).…”

Section: Discussionmentioning

confidence: 98%

<p>Pattern of Cardiac Diseases and Co-Existing Morbidities Among Newly Registered Cardiac Patients in an Adult Cardiac Referral Clinic of Hawassa University Comprehensive Specialized Hospital, Southern-Ethiopia</p>

Shifeta¹,

Hirigo²

2020

VHRM

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Background: Currently, cardiovascular diseases (CVDs) are rising in the world and require great concern because the consequences are not only morbidity and mortality, but also a high economic burden. However, the pattern of CVDs in Ethiopia is not well known. Therefore, this study aimed to describe CVD and co-existing morbidities among newly registered cardiac patients in Hawassa University Comprehensive Specialized Hospital. Methods: A retrospective cross-sectional study was conducted from January 1 to December 31, 2016 among newly registered cardiac patients in an adult cardiac referral clinic. Records and cardiac referral clinic logbooks were used to collect relevant information using structured checklists. Results: Of the total 310 records of cardiac patients, 236 were explored and included in the study, while the records of 74 patients were absent in the cards room when tracing and/or incomplete to assess cardiac pattern. Rheumatic heart disease (RHD) was the leading cardiac problem and diagnosed in 70 (29.7%) cases followed by non-ischemic cardiomyopathy (55, 23.3%), ischemic heart disease (41, 17.4%), hypertensive heart disease (29, 12.3%), and cor pulmonale (14, 5.9%). The mean age of RHD patients was 28.7 (±13.1) years. Eighty-two (35%) females and 23 (19.8%) males had RHD, while 69 (29.2%) females and 23 (19.8%) males had non-ischemic cardiomyopathy. The overall rate of mitral stenosis, mitral regurgitation, and aortic regurgitation among patients with RHD were 39 (55.7%), 48 (68.6%), and 26 (37.1%), respectively. Moreover, the overall coexisted morbidity was 81 (34.3%), with a high rate of hypertension alone at 44 (18.6%) followed by hypertension with diabetes at 11 (4.7%). Conclusion: This study indicated that more than one-third of cardiac patients had at least one of the co-existing morbidities like hypertension, diabetes mellitus, asthma and other diseases. Therefore, careful diagnosis and management of cardiac patients plays an important role to minimize comorbidity-linked complications. Moreover, population-based studies are recommended for better representing and generalization.

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Section: Discussionmentioning

confidence: 98%

<p>Pattern of Cardiac Diseases and Co-Existing Morbidities Among Newly Registered Cardiac Patients in an Adult Cardiac Referral Clinic of Hawassa University Comprehensive Specialized Hospital, Southern-Ethiopia</p>

Shifeta¹,

Hirigo²

2020

VHRM

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“…This ratio is in agreement with a recent prospective multicentre echocardiographic registry. 31 Therapeutic approaches for SMR remain a matter of debate and the benefit of surgical correction of SMR is disputed. 13 32 33 Interestingly and despite these uncertainties, half of the patients with SMR underwent an isolated MV surgery, a markedly higher rate than one might have expected.…”

Section: Discussionmentioning

confidence: 99%

Presentation and outcomes of mitral valve surgery in France in the recent era: a nationwide perspective

et al. 2020

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ObjectivesUnbiased information regarding the surgical management of patients with mitral regurgitation (MR) at the nationwide level are scarce and mainly US-based. The Programme de Médicalisation des Systèmes d’Information, a mandatory national database, offers the unique opportunity to assess the presentation and outcomes of all consecutive mitral valve (MV) surgeries performed in France in the contemporary era.MethodsWe collected all MV surgeries performed for MR in France in 2014–2016. MR aetiology was classified as degenerative (DMR), secondary (SMR) or Other (rheumatic or congenital disease and infective endocarditis).ResultsDuring the 3-year period, 18 167 MV surgeries were performed in France (55% repair and 45% replacement; 52% isolated). Age was 66±12 years and 59% were male. Aetiology was DMR in 42%, SMR in 16% and other in 42% including 19% with uncertain aetiologies. Overall, in-hospital mortality was 6.5% and increased with age, female gender, Charlson Comorbidity Index, type of surgery (replacement vs repair), associated surgery (combined vs isolated) and MR aetiology (all p<0.01). In-hospital mortality and rate of death/readmission for heart failure (HF) at 1 year were 3.4% and 13%, respectively for DMR (2.4% and 11% for isolated DMR) and 7.8% and 27%, respectively for SMR (5.5% and 23% for isolated SMR). Repair rate was 55% overall, 68% in DMR and 72% for isolated DMR surgery (70% of all DMR). Repair rates decreased with age, Charlson Comorbidity Index and female sex (all p<0.0001).ConclusionIn this cross-sectional contemporary prospective nationwide database, in-hospital mortality and 1 year rate of death and HF readmission were considerable overall and in all subsets. Repair rates were suboptimal overall especially in the elderly and women subsets. These results underline the need to develop strategies to improve management and outcomes of patients with both DMR and SMR.

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“…In fact, progressive sMR occurs in 20%‐30% of patients with nonsevere sMR despite GDT and is independently associated with a more than twofold increased risk of death . Defining patients at risk for progression is mandatory as in this patient subpopulation more invasive early treatment strategies are available but the level of evidence in guideline recommendations is weak . Whilst it has been shown that invasive treatment for sMR can delay or even prevent progressive HF, characteristics of patients that may benefit most and the optimal time‐point for intervention are not ultimately determined .…”

Section: Discussionmentioning

confidence: 99%

Phenotyping progression of secondary mitral regurgitation in chronic systolic heart failure

Arfsten

Bartko

Pávó

et al. 2019

Eur J Clin Investigation

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BackgroundSecondary mitral regurgitation (sMR) drives adverse cardiac remodelling in patients with heart failure with reduced ejection fraction (HFrEF). Progression in severity over time contributes to a transition towards more advanced HF stages. Early identification of patients at risk for sMR progression remains challenging. We therefore sought to assess a broad spectrum of neurohumoral biomarkers in patients with HFrEF to explore their ability to predict progression of sMR.MethodsA total of 249 HFrEF patients were enrolled. Biomarkers encompassing key neurohumoral pathways in heart failure were sampled at baseline, and sMR progression was assessed over 3 years of follow‐up.ResultsOf 191 patients with nonsevere sMR at baseline, 18% showed progressive sMR within three years after study enrolment. Progression of sMR was associated with higher levels of MR‐proADM (adj.OR 2.25, 95% CI 1.29‐3.93; P = .004), MR‐proANP (adj.OR 1.84, 95% CI 1.14‐3.00; P = .012), copeptin (adj.OR 1.66, 95% CI 1.04‐2.67; P = .035) and CT‐pro‐ET1 (adj.OR 1.68, 95% CI 1.06‐2.68; P = .027) but not with NT‐proBNP (P = .54).ConclusionIncreased plasma levels of neurohumoral cardiac biomarkers are predictors of sMR progression in patients with HFrEF and add easily available incremental prognostic information for risk stratification. Importantly, NT‐proBNP was not useful to predict progressive sMR in the present analysis. On the contrary, MR‐proANP, primarily produced in the atria, copeptin partly triggered by intra‐cardiac and intra‐arterial pressures and MR‐proADM, a marker of forward failure and peripheral released vasoactive CT‐proET1, increase based on a progressive loading burden by sMR and may thus serve as better predictors of sMR progression.

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Overview of mitral regurgitation in Europe: results from the European Registry of mitral regurgitation (EuMiClip)

Cited by 45 publications

References 14 publications

<p>Pattern of Cardiac Diseases and Co-Existing Morbidities Among Newly Registered Cardiac Patients in an Adult Cardiac Referral Clinic of Hawassa University Comprehensive Specialized Hospital, Southern-Ethiopia</p>

<p>Pattern of Cardiac Diseases and Co-Existing Morbidities Among Newly Registered Cardiac Patients in an Adult Cardiac Referral Clinic of Hawassa University Comprehensive Specialized Hospital, Southern-Ethiopia</p>

Presentation and outcomes of mitral valve surgery in France in the recent era: a nationwide perspective

Phenotyping progression of secondary mitral regurgitation in chronic systolic heart failure

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