Functional mitral regurgitation severity was a strong, independent predictor of 1-year mortality in elderly patients with systolic chronic heart failure (OR 4.47; 95% CI 1.50-13.0).
Cohort (n=175)
Does functional mitral regurgitation predict 1-year mortality and hospitalization in elderly patients with systolic chronic heart failure?
Functional mitral regurgitation is a strong, independent predictor of 1-year mortality, but not hospitalization, in elderly patients with systolic chronic heart failure.
Effect estimate: OR 4.47 (95% CI 1.50-13.0)
p-value: p=0.00001
Abstract Background and aim Mitral regurgitation (MR) has been demonstrated to be a powerful predictor of adverse outcome in middle-aged patients with chronic heart failure (CHF). In this study, we sought to define the prognostic impact of functional mitral regurgitation in a population of elderly patients with systolic CHF. Methods One hundred seventy-five outpatients aged 70 years with validated CHF and left ventricular ejection fraction 40% underwent clinical and echocardiographic evaluations at baseline. Mitral regurgitation was diagnosed by Color Doppler and quantified in 5 categorical values using a 0–4+ grading system. Outcome measures included 1-year mortality and hospitalization for worsening CHF. Results The distribution of patients according to the 5 different degrees of MR detected at baseline was: absent=11%, 1+=31%, 2+=38%, 3+=16%, 4+=4%. The relationship between MR and mortality was direct and approximately linear (r=0.39, p=0.00001). The prevalence of death in the 5 subgroups was 0%, 7%, 15%, 45%, 57%, respectively. Multivariate logistic regression analysis showed that MR was the strongest predictor of death (OR 4.47, 95% CI 1.50–13.0), independently of the presence of diabetes mellitus, older age and larger left ventricular end-diastolic volume. No association was found between MR and hospitalization for worsening CHF (r=0.08, p=0.41). Conclusions This study establishes the direct and independent relationship between MR severity and one-year mortality among elders with systolic CHF. Conversely, MR does not provide useful information regarding the risk of subsequent hospitalization for worsening CHF.
Cioffi et al. (Wed,) conducted a cohort in Systolic chronic heart failure (n=175). Functional mitral regurgitation was evaluated on 1-year mortality (OR 4.47, 95% CI 1.50-13.0, p=0.00001). Functional mitral regurgitation severity was a strong, independent predictor of 1-year mortality in elderly patients with systolic chronic heart failure (OR 4.47; 95% CI 1.50-13.0).