Cardiac Function, Haemodynamics, and Valve Competence with Exercise in Patients with Heart Failure with Preserved Ejection Fraction and Mild to Moderate Secondary Mitral Regurgitation
Key result
Mild-to-moderate secondary MR in HFpEF is linked to 3 mmHg higher PAWP and worse LA myopathy.
- P=0.005
- n=182
Why the study?
The clinical significance of secondary mitral regurgitation in patients with heart failure with preserved ejection fraction was unclear.
Does mild or moderate secondary mitral regurgitation affect cardiac function and haemodynamics during exercise in patients with HFpEF?
Population
Consecutively evaluated HFpEF patients undergoing invasive haemodynamic exercise testing with simultaneous echocardiography
Comparison
Mild or moderate MR (n = 37) vs without MR (n = 145)
Design
Prospective observational study
Authors
Discussion
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Member takes
Implication
Secondary MR marks advanced HFpEF with elevated pressures; leaves open whether it is causal or modifiable.
Study Design
Type
Observational (n=182)
Structured PICO
Does mild or moderate secondary mitral regurgitation affect cardiac function and haemodynamics during exercise in patients with HFpEF?
P
Population
182 patients with heart failure with preserved ejection fraction (HFpEF) undergoing invasive haemodynamic exercise testing with simultaneous echocardiography
I
Intervention
Presence of mild or moderate secondary mitral regurgitation (MR)
C
Comparator
HFpEF without MR
O
Outcome
Cardiac function, haemodynamics, and valve competence at rest and with exercisesurrogate
Main Result
Absolute Event Rate: 20% vs 17%
p-value: p=0.005
In patients with HFpEF, mild or moderate secondary mitral regurgitation serves as a phenotypic marker of more advanced disease, including more severe LV systolic dysfunction and LA myopathy, rather than a causal factor.
Cite This Study
Harada et al. (2024) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=182). Mild or moderate secondary mitral regurgitation vs. No mitral regurgitation was evaluated on Pulmonary artery wedge pressure at rest (p=0.005). Mild or moderate secondary mitral regurgitation in HFpEF is associated with higher resting pulmonary artery wedge pressure (20 vs 17 mmHg, p=0.005) and more severe left atrial myopathy.