Long-term outcomes of mitral regurgitation by type and severity

American Heart Journal
Zainab SamadEric J Velazquez

Abstract

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 of >60%; primary non-myxomatous, secondary ischemic, and non-ischemic MR had survival rates <50%. 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 ...Continue Reading

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Citations

May 23, 2019·International Journal of Computer Assisted Radiology and Surgery·Olivia K GintyTerry M Peters
Dec 7, 2019·Interactive Cardiovascular and Thoracic Surgery·Maria von StummEvaldas Girdauskas
Jun 14, 2021·The Canadian Journal of Cardiology·Makoto MoriArnar Geirsson
Aug 29, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alec VahanianUNKNOWN ESC/EACTS Scientific Document Group
Aug 29, 2021·European Heart Journal·Alec VahanianUNKNOWN ESC Scientific Document Group
Dec 22, 2021·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Alec VahanianWojtek Wojakowski

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