Independent prognostic value of functional mitral regurgitation in patients with heart failure. A quantitative analysis of 1256 patients with ischaemic and non-ischaemic dilated cardiomyopathy

Andrea Rossi, Frank L. Dini, Pompilio Faggiano, Eustachio Agricola, Mariantonietta Cicoira, Silvia Frattini, Anca Simioniuc, Mariangela Gullace, Stefano Ghio, Maurice Enriquez-Sarano, Pier Luigi Temporelli

Research output: Contribution to journalArticle

272 Scopus citations

Abstract

Background: Functional mitral regurgitation (FMR) is a common finding in patients with heart failure (HF), but its effect on outcome is still uncertain, mainly because in previous studies sample sizes were relatively small and semiquantitative methods for FMR grading were used. Objective: To evaluate the prognostic value of FMR in patients with HF. Methods and results: Patients with HF due to ischaemic and non-ischaemic dilated cardiomyopathy (DCM) were retrospectively recruited. The clinical end point was a composite of all-cause mortality and hospitalisation for worsening HF. FMR was quantitatively determined by measuring vena contracta (VC) or effective regurgitant orifice (ERO) or regurgitant volume (RV). Severe FMR was defined as ERO >0.2 cm 2 or RV >30 ml or VC >0.4 cm. Restrictive mitral filling pattern (RMP) was defined as E-wave deceleration time <140 ms. The study population comprised 1256 patients (mean age 67±11; 78% male) with HF due to DCM: 27% had no FMR, 49% mild to moderate FMR and 24% severe FMR. There was a powerful association between severe FMR and prognosis (HR=2.0, 95% CI 1.5 to 2.6; p<0.0001) after adjustment of left ventricular ejection fraction and RMP. The independent association of severe FMR with prognosis was confirmed in patients with ischaemic DCM (HR=2.0, 95% CI 1.4 to 2.7; p<0.0001) and nonischaemic DCM (HR=1.9, 95% CI 1.3 to 2.9; p=0.002). Conclusion: In a large patient population it was shown that a quantitatively defined FMR was strongly associated with the outcome of patients with HF, independently of LV function.

Original languageEnglish (US)
Pages (from-to)1675-1680
Number of pages6
JournalHeart
Volume97
Issue number20
DOIs
StatePublished - Oct 1 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Independent prognostic value of functional mitral regurgitation in patients with heart failure. A quantitative analysis of 1256 patients with ischaemic and non-ischaemic dilated cardiomyopathy'. Together they form a unique fingerprint.

  • Cite this