Prevalence and Prognostic Significance of Mitral Regurgitation in Acute Decompensated Heart Failure

Arora, Sameer; Sivaraj, Krishan; Hendrickson, Michael; Chang, Patricia; Weickert, Thelsa; Qamar, Arman; Vaduganathan, Muthiah; Caughey, Melissa C.; Pandey, Ambarish; Cavender, Matthew A.; Rosamond, Wayne D.; Vavalle, John P.

doi:10.1016/j.jchf.2020.09.015

Cited by 31 publications

(56 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar results were also found in the ARIC analysis where moderate or severe MR was an independent predictor of 1-year mortality only in patients with LVEF <50%. 20 11,29,36,37 Our analysis of a large study group allowed the assessment of the role of MR according to the severity of HF. In our study, the prognostic impact of moderate-severe MR on clinical outcome seemed more evident in patients with NT-proBNP ≥3619 pg/mL and, consistently, in those with reduced LVEF and larger LV volumes.…”

Section: Discussionmentioning

confidence: 99%

Impact of mitral regurgitation in patients with worsening heart failure: insights from BIOSTAT‐CHF

Pagnesi

Adamo

Sama

et al. 2021

European J of Heart Fail

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of mitral regurgitation in patients with worsening heart failure: insights from BIOSTAT‐CHF

Pagnesi

Adamo

Sama

et al. 2021

European J of Heart Fail

View full text Add to dashboard Cite

show abstract

“…Although we have advanced our understanding of FMR in chronic heart failure, there still remains a paucity of data pertaining to FMR in the setting of acute decompensated heart failure (ADHF). 11 , 12 , 13 , 14 Patients presenting with ADHF are in a state of increased ventricular loading conditions 15 and it remains unclear whether FMR in this setting is simply a marker of preload and after‐load mismatch or if it also carries any long‐term prognostic significance. Notably, FMR in the setting of ADHF is highly susceptible to pharmacological optimization.…”

mentioning

confidence: 99%

Severity of Functional Mitral Regurgitation on Admission for Acute Decompensated Heart Failure Predicts Long‐Term Risk of Rehospitalization and Death

Kataria

Castagna

Madan

et al. 2022

JAHA

View full text Add to dashboard Cite

Background Functional mitral regurgitation (FMR) has emerged as a therapeutic target in patients with chronic heart failure and left ventricular systolic dysfunction. The significance of FMR in acute decompensated heart failure remains obscure. We systematically investigated the prevalence and clinical significance of FMR on admission in patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction. Methods and Results The study was a single‐center, retrospective review of patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction between 2012 and 2017. Patients were divided into 3 groups of FMR: none/mild, moderate, and moderate‐to‐severe/severe FMR. The primary outcome was 1‐year post‐discharge all‐cause mortality. We also compared these groups for 6‐month heart failure hospitalization rates. Of 2303 patients, 39% (896) were women. Median left ventricular ejection fraction was 25%. Four hundred and fifty‐three (20%) patients had moderate‐to‐severe/severe FMR, which was independently associated with 1‐year all‐cause mortality. Moderate or worse FMR was found in 1210 (53%) patients and was independently associated with 6‐month heart failure hospitalization. Female sex was independently associated with higher severity of FMR. Conclusions More than half of patients hospitalized with acute decompensated heart failure and left ventricular systolic dysfunction had at least moderate FMR, which was associated with increased readmission rates and mortality. Intensified post‐discharge follow‐up should be undertaken to eliminate FMR amenable to pharmacological therapy and enable timely and appropriate intervention for persistent FMR. Further studies are needed to examine sex‐related disparities in FMR.

show abstract

“…An article published by the Journal of the American College of Cardiology (JACC) demonstrated that moderate or severe MR was not independently associated with 1-year mortality among patients with acute decompensated HF (ADHF) who had LVEF ≥ 50% ( 12 ). Another study demonstrated that MR has a negative effect on prognosis only in patients with severely reduced LVEF ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

“…The 2021 European Society of Cardiology (ESC) guidelines for the management of secondary MR in patients with HF recommended that patients undergoing PCI with HF complicated by moderate or severe MR should be considered for further treatment to improve the current poor prognosis (12). However, current CAD management guidelines do not provide convincing evidence in patients undergoing PCI with or without HF (26)(27)(28)(29)(30).…”

Section: Discussionmentioning

confidence: 99%

“…With improvement in management, the treatment rate of PCI is increasing in patients with CAD with HF, but the prognosis remains poor because of complicated clinical features (9). Previous studies have demonstrated that moderate or severe MR is common among patients with HF and associated with poor prognosis (10)(11)(12), while the role of moderate or severe MR in patients with HF undergoing PCI has been poorly addressed. Furthermore, whether there is higher incidence and mortality of moderate or severe MR among PCI with HF compared to those without has not been previously reported.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and Mortality of Moderate or Severe Mitral Regurgitation Among Patients Undergoing Percutaneous Coronary Intervention With or Without Heart Failure: Results From CIN Study With 28,358 Patients

Huang

Jin

Bao

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

AimThis study investigated the prevalence and mortality associated with moderate or severe mitral regurgitation (MR) among patients undergoing percutaneous coronary intervention (PCI), with or without heart failure (HF).MethodsWe analyzed patients undergoing PCI without mitral valve surgery from the Cardiorenal ImprovemeNt (CIN) study (ClinicalTrials.gov NCT04407936). Patients without echocardiography to determine MR occurrence or lacking follow-up death data were excluded. Primary endpoints were 1-year and long-term all-cause mortality, with a median follow-up time of 5 years (interquartile range: 3.1–7.6).ResultsOf 28,358 patients undergoing PCI treatment [mean age: 62.7 ± 10.7; women: 6,749 (25.6%)], 3,506 (12.4%) had moderate or severe MR, and there was a higher rate of moderate or severe MR in HF group than non-HF group (28.8 vs. 5.6%, respectively). Regardless of HF conditions, patients with moderate or severe MR were older and had worse cardio-renal function and significantly increased 1-year mortality [adjusted hazard ratio (aHR): 1.82, 95% confidence interval (CI): 1.51–2.2], and long-term mortality [aHR: 1.43, 95% CI: 1.3–1.58]. There was no significant difference between patients with HF and those with non-HF (P for interaction > 0.05).ConclusionOne-eighth of the patients undergoing PCI had moderate or severe MR. Furthermore, one-third and one-seventeenth experienced moderate or severe MR with worse cardiorenal function in the HF and non-HF groups, and increased consistent mortality risk. Further studies should explore the efficacy of mitral interventional procedures for moderate or severe MR after PCI treatment, regardless of HF.

show abstract

Prevalence and Prognostic Significance of Mitral Regurgitation in Acute Decompensated Heart Failure

Cited by 31 publications

References 22 publications

Impact of mitral regurgitation in patients with worsening heart failure: insights from BIOSTAT‐CHF

Impact of mitral regurgitation in patients with worsening heart failure: insights from BIOSTAT‐CHF

Severity of Functional Mitral Regurgitation on Admission for Acute Decompensated Heart Failure Predicts Long‐Term Risk of Rehospitalization and Death

Prevalence and Mortality of Moderate or Severe Mitral Regurgitation Among Patients Undergoing Percutaneous Coronary Intervention With or Without Heart Failure: Results From CIN Study With 28,358 Patients

Contact Info

Product

Resources

About