Key result
TAPSE <16 mm (HR 2.64; p=0.009) and plasma NT-proBNP ≥3283 pg/ml (HR 2.58; p=0.011) were significant independent predictors of all-cause mortality in patients with systolic HF and functional MR.
Why the study?
Do TAPSE < 16 mm and plasma NT-proBNP >= 3283 pg/ml predict all-cause mortality in patients with systolic heart failure and moderate-to-severe functional mitral regurgitation?
Cohort (n=142)
Do TAPSE < 16 mm and plasma NT-proBNP >= 3283 pg/ml predict all-cause mortality in patients with systolic heart failure and moderate-to-severe functional mitral regurgitation?
In patients with systolic heart failure and functional mitral regurgitation, reduced right ventricular function (TAPSE < 16 mm) and elevated NT-proBNP (>= 3283 pg/ml) are strong independent predictors of all-cause mortality.
Answers are grounded in this paper and cite their sources.
May aid mortality risk stratification in systolic HF with functional MR; hypothesis-generating, requiring prospective validation before clinical adoption.
BACKGROUND: The role of the right ventricle has been relatively neglected proportionate to its importance. We sought to evaluate the impact of right ventricular (RV) and NT-proBNP on the outcome of patients with heart failure (HF) and functional mitral regurgitation (MR). METHODS AND PATIENTS: Outpatients with left ventricular (LV) systolic HF (ejection fraction [EF] < or =45%) and moderate-to-severe MR measured by a vena contracta width > or =0.5 cm were prospectively enrolled (n=142). Indexes of LV and RV function, including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change and tissue Doppler RV acceleration at isovolumic contraction and NT-proBNP plasma levels were measured at the time of the index echocardiogram. RESULTS: Multivariate predictors of all-cause mortality included TAPSE<16 mm (hazards ratio [HR]: 2.64; p=0.009) and plasma NT-proBNP> or =3283 pg/ml (HR: 2.58; p=0.011). TAPSE<16 mm and plasma NT-proBNP> or =3283 pg/ml added incremental prognostic information to LV EF< or =25%, NYHA classes 3-4, coronary artery disease, elderly age and male sex. The 36-month Kaplan-Meier curve showed that survival was worst in the group with TAPSE<16 mm and NT-proBNP> or =3283 pg/ml (p<0.0001). CONCLUSION: This study demonstrates the significance of TAPSE and plasma NT-proBNP in predicting all-cause mortality in patients with systolic HF and moderate-to-severe functional MR.
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Dini et al. (2008) conducted a cohort in Heart failure and moderate-to-severe functional mitral regurgitation (n=142). TAPSE and plasma NT-proBNP was evaluated on All-cause mortality (HR 2.64 (TAPSE <16 mm); HR 2.58 (NT-proBNP ≥3283 pg/ml), p=0.009 (TAPSE); 0.011 (NT-proBNP)). TAPSE <16 mm (HR 2.64; p=0.009) and plasma NT-proBNP ≥3283 pg/ml (HR 2.58; p=0.011) were significant independent predictors of all-cause mortality in patients with systolic HF and functional MR.
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