Prognosis of patients with secondary mitral regurgitation ...

[Pages:16]Open Heart: first published as 10.1136/openhrt-2017-000745 on 9 January 2018. Downloaded from on March 30, 2022 by guest. Protected by copyright.

Open Access

Valvular heart disease

Prognosis of patients with secondary mitral regurgitation and reduced ejection fraction

Samer Mowakeaa,1 Aeshita Dwivedi,2 Jason R Grossman,3 Gaurav Parikh,4 Zelmira Curillova,5 Krishna G Aragam,6,7 Sammy Elmariah,6,7 Scott Kinlay,6,8,9 Jayashri Aragam6,8

To cite: Mowakeaa S, Dwivedi A, Grossman JR, et al. Prognosis of patients with secondary mitral regurgitation and reduced ejection fraction. Open Heart 2018;5:e000745. doi:10.1136/ openhrt-2017-000745

SM and AD contributed equally.

This study was conducted in the Veterans Administration Boston Healthcare System in West Roxbury, Massachusetts, USA. The findings of this study were presented in poster format at the American Society of Echocardiography Scientific Sessions in Minneapolis, Minnesota, USA, 2013.

Received 6 November 2017 Revised 17 November 2017 Accepted 18 November 2017

Abstract Objective The impact of the severity of secondary mitral regurgitation (MR) on the risk of death and heart failure (HF) hospitalisations in patients with reduced left ventricular (LV) systolic function is poorly defined. The study sought to identify the incremental risk of secondary MR in patients with reduced LV systolic function. Methods We studied 615 consecutive patients with LV ejection fraction 35% by transthoracic echocardiography at a single medical centre. Patients were divided into three groups of no MR, mild, or moderate to severe MR. The median follow-up was 2.9 years. The primary endpoint was a composite of death or HF hospitalisations. Results Compared with patients with no MR, the risk of death or HF hospitalisations was higher for mild MR (HR 1.7, P=0.003) and moderate to severe MR (HR 2.7, P ................
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