Mitral Annular Tissue Velocity Predicts Survival in Patients With Primary Mitral Regurgitation.

Autor: Choi YJ; Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. flyiing48@gmail.com., Park CS; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea., Rhee TM; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea., Lee HJ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea., Choi HM; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea., Hwang IC; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea., Park JB; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea., Yoon YE; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea., Na JO; Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea., Kim HK; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea., Kim YJ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea., Cho GY; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea., Sohn DW; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea., Lee SP; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. sproll1@snu.ac.kr.
Jazyk: angličtina
Zdroj: Korean circulation journal [Korean Circ J] 2024 Jun; Vol. 54 (6), pp. 311-322.
DOI: 10.4070/kcj.2023.0292
Abstrakt: Background and Objectives: Early diastolic mitral annular tissue (e') velocity is a commonly used marker of left ventricular (LV) diastolic function. This study aimed to investigate the prognostic implications of e' velocity in patients with mitral regurgitation (MR).
Methods: This retrospective cohort study included 1,536 consecutive patients aged <65 years with moderate or severe chronic primary MR diagnosed between 2009 and 2018. The primary and secondary outcomes were all-cause and cardiovascular mortality, respectively. According to the current guidelines, the cut-off value of e' velocity was defined as 7 cm/s.
Results: A total of 404 individuals were enrolled (median age, 51.0 years; 64.1% male; 47.8% severe MR). During a median 6.0-year follow-up, there were 40 all-cause mortality and 16 cardiovascular deaths. Multivariate analysis revealed a significant association between e' velocity and all-cause death (adjusted hazard ratio [aHR], 0.770; 95% confidence interval [CI], 0.634-0.935; p=0.008) and cardiovascular death (aHR, 0.690; 95% CI, 0.477-0.998; p=0.049). Abnormal e' velocity (≤7 cm/s) independently predicted all-cause death (aHR, 2.467; 95% CI, 1.170-5.200; p=0.018) and cardiovascular death (aHR, 5.021; 95% CI, 1.189-21.211; p=0.028), regardless of symptoms, LV dimension and ejection fraction. Subgroup analysis according to sex, MR severity, mitral valve replacement/repair, and symptoms, showed no significant interactions. Including e' velocity in the 10-year risk score improved reclassification for mortality (net reclassification improvement [NRI], 0.154; 95% CI, 0.308-0.910; p<0.001) and cardiovascular death (NRI, 1.018; 95% CI, 0.680-1.356; p<0.001).
Conclusions: In patients aged <65 years with primary MR, e' velocity served as an independent predictor of all-cause and cardiovascular deaths.
Competing Interests: The authors have no financial conflicts of interest.
(Copyright © 2024. The Korean Society of Cardiology.)
Databáze: MEDLINE