Key result
Patients with severe asymptomatic mitral regurgitation had significantly lower myocardial efficiency compared to healthy volunteers (25% vs. 44%, p < 0.001) due to increased myocardial oxygen consumption.
Why the study?
Determining left ventricular systolic performance in severe mitral regurgitation is challenging because EF can remain preserved until end-stage disease.
Is myocardial efficiency reduced in patients with asymptomatic severe mitral regurgitation compared to healthy volunteers?
Cross-Sectional (n=53)
No
Is myocardial efficiency reduced in patients with asymptomatic severe mitral regurgitation compared to healthy volunteers?
Absolute Event Rate: 25% vs 44%
p-value: p=<0.001
Myocardial efficiency is significantly reduced in patients with asymptomatic severe mitral regurgitation and preserved ejection fraction, driven by increased myocardial oxygen consumption.
Myocardial efficiency reduction in asymptomatic severe MR should not yet change practice; leaves open its prognostic and therapeutic relevance.
BACKGROUND: It is difficult to determine left ventricular systolic performance in patients with severe mitral regurgitation (MR) since left ventricular ejection fraction (EF) could be preserved until the end stages of the disease. Myocardial efficiency (MEf) describes the amount of external work (EW) done by the left ventricle per unit of oxygen consumed (mVO₂). In the present study, we aimed to investigate MEf in patients with asymptomatic severe MR using a novel echocardiographic method. METHODS: A total of 27 patients with severe asymptomatic MR and 26 healthy volunteers were included in this cross-sectional study. EW was measured using stroke volume and blood pressure, while mVO₂ was estimated using double product and left ventricular mass. RESULTS: ̅: 0.24, 95% CI: 0.19-0.29 for patients with severe MR). Further analysis showed that this reduction was due to an increase in total mVO₂ in the severe MR group. MEf of thepatients who were both on β-blockers and angiotensin converting enzyme inhibitors/angiotensin receptor blockers were higher than those who were not on any drugs, but this difference was not statistically significant (32% ± 15% vs. 23% ± 9%, p = 0.41). CONCLUSIONS: MEf was significantly lower in patients with asymptomatic severe MR and preserved EF.
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Güvenç et al. (2020) conducted a cross-sectional in Severe asymptomatic mitral regurgitation (n=53). Severe asymptomatic mitral regurgitation vs. Healthy volunteers was evaluated on Myocardial efficiency (MEf) (p=<0.001). Patients with severe asymptomatic mitral regurgitation had significantly lower myocardial efficiency compared to healthy volunteers (25% vs. 44%, p < 0.001) due to increased myocardial oxygen consumption.
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