Long-term outcomes of mitral regurgitation by type and severity
| Autor: | Joseph Kisslo, Daniel B. Mark, Andrew Wang, Zainab Samad, Mads Ersbøll, John H. Toptine, John H. Alexander, Matthew Phelan, Linda K. Shaw, Eric J. Velazquez, Donald D. Glower |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Death risk 030204 cardiovascular system & hematology Severity of Illness Index Ventricular Function Left Coronary artery disease 03 medical and health sciences 0302 clinical medicine Cause of Death Internal medicine Severity of illness medicine Long term outcomes Humans 030212 general & internal medicine Aged Retrospective Studies Mitral regurgitation business.industry Mortality rate Left ventricular size Mitral Valve Insufficiency Stroke Volume Retrospective cohort study Middle Aged Prognosis medicine.disease United States Echocardiography Doppler Color Survival Rate Cardiology Mitral Valve Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | American Heart Journal. 203:39-48 |
| ISSN: | 0002-8703 |
| Popis: | We aimed to determine the association of MR severity and type with all-cause death in a large, real-world, clinical setting.We reviewed full echocardiography studies at Duke Echocardiography Laboratory (01/01/1995-12/31/2010), classifying MR based on valve morphology, presence of coronary artery disease, and left ventricular size and function. Survival was compared among patients stratified by MR type and baseline severity.Of 93,007 qualifying patients, 32,137 (34.6%) had ≥mild MR. A total of 8094 (8.7%) had moderate/severe MR, which was primary myxomatous (14.1%), primary non-myxomatous (6.2%), secondary non-ischemic (17.0%), and secondary ischemic (49.4%). At 10 years, patients with primary myxomatous MR or MR due to indeterminate cause had survival rates of60%; primary non-myxomatous, secondary ischemic, and non-ischemic MR had survival rates50%. While mild (HR 1.06, 95% CI 1.03-1.09), moderate (HR 1.31, 95% CI 1.27-1.37), and severe (HR 1.55, 95% CI 1.46-1.65) MR were independently associated with all-cause death, the relationship of increasing MR severity with mortality varied across MR types (P ≤ .001 for interaction); the highest risk associated with worsening severity was seen in primary myxomatous MR followed by secondary ischemic MR and primary non-myxomatous MR.Although MR severity is independently associated with increased all-cause death risk for most forms of MR, the absolute mortality rates associated with worse MR severity are much higher for primary myxomatous, non-myxomatous, and secondary ischemic MR. The findings from this study support carefully defining MR by type and severity. |
| Databáze: | OpenAIRE |
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