Long-term prognosis of medically treated patients with functional mitral regurgitation and left ventricular dysfunction

Eustachio Agricola, Alfonso Ielasi, Michele Oppizzi, Pompilio Faggiano, Luca Ferri, Alice Calabrese, Enrico Vizzardi, Ottavio Alfieri, Alberto Margonato

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To assess long-term prognosis in patients with functional mitral regurgitation (FMR) and left ventricular (LV) dysfunction, receiving current standard pharmacological therapy.Methods and results: We prospectively enrolled 404 consecutive patients (mean age 70.2 ± 10 years) with ischaemic (76.5%) and non-ischaemic (23.5%) LV dysfunction (ejection fraction 34.4 ± 10.8%) and at least mild MR. Results are reported at 4 years' follow-up. Survival free of all-cause mortality was 53% and cardiac death was 74%. Survival free of all-cause mortality was 50% (95% CI 35-72) for patients with moderate MR, 49% (95% CI 27-65) for severe MR, and 64% (95% CI 47-78) for mild MR (P = 0.03). Survival free of cardiac death was 57% (95% CI 38-74) for patients with moderate MR, 55% (95% CI 30-77) for severe MR, and 94% (95% CI 59-98) for mild MR (P = 0.003). Moderate-to-severe MR [relative risk (RR) 2.7, 95% CI 1.2-6.1, P = 0.003] was an independent predictor of cardiac death but not of all-cause mortality. Survival free of heart failure (HF) was 32%. Survival free of HF was 20% (95% CI 17-35) for patients with moderate MR, 18% (95% CI 15-32) for severe MR, and 62% (95% CI 45-72) for mild MR (P = 0.0001). Moderate-to-severe MR (RR 3.2, 95% CI 1.9-5.2, P = 0.0001) was an independent predictor of HF.Conclusion: The mortality and morbidity of patients with LV dysfunction and FMR remain high despite current standard pharmacological therapy. Moderate-to-severe MR is an independent predictor of cardiac death and HF.

Original languageEnglish
Pages (from-to)581-587
Number of pages7
JournalEuropean Journal of Heart Failure
Volume11
Issue number6
DOIs
Publication statusPublished - Jun 2009

Keywords

  • Heart failure
  • Mitral valve
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Long-term prognosis of medically treated patients with functional mitral regurgitation and left ventricular dysfunction'. Together they form a unique fingerprint.

Cite this