Moderate/severe mitral regurgitation in acute heart failure was associated with increased all-cause mortality compared to no/mild regurgitation (OR 1.47; 95% CI 1.30-1.66; p<0.001).
Meta-Analysis (n=73,363)
Does moderate/severe mitral regurgitation increase all-cause mortality in patients with acute heart failure?
Moderate to severe mitral regurgitation in acute heart failure is associated with a significantly increased risk of all-cause mortality, particularly in patients with LVEF ≤50%.
Odds Ratio: 1.47 (95% CI 1.3–1.66)
p-value: p=<0.001
AIMS: Despite previous studies investigating the impact of mitral regurgitation (MR) in acute heart failure (AHF) there are inconsistencies in trial data, and no meta-analyses to date. Our aim was to explore if MR is associated with mortality in AHF. METHODS AND RESULTS: We performed a meta-analysis of AHF patients with MR to investigate any association with all-cause mortality. We identified 27 studies that met our inclusion criteria, encompassing 73,363 patients (age 72.9±4.2years; females 44.4%) with an average follow-up of 1.9 years. Moderate/severe MR was associated with an unadjusted 47% increased mortality risk compared to no/mild MR (OR 1.47 95% CI 1.30-1.66, p50% (OR 1.16 [95% CI 0.91-1.47, p=0.23. Neither meta-regression nor pre-specified sensitivity analyses affected MR's association with the primary outcome. A substantial degree of heterogeneity was observed across the included studies. CONCLUSIONS: We observed that MR during AHF is associated with increased mortality. Although causality cannot be inferred due to the observational design and high heterogeneity of the included studies, MR may represent a phenotype amenable to targeted therapies during decompensated heart failure.
Berrill et al. (Mon,) conducted a meta-analysis in Acute heart failure (n=73,363). Moderate/severe mitral regurgitation vs. No/mild mitral regurgitation was evaluated on All-cause mortality (OR 1.47, 95% CI 1.30-1.66, p=<0.001). Moderate/severe mitral regurgitation in acute heart failure was associated with increased all-cause mortality compared to no/mild regurgitation (OR 1.47; 95% CI 1.30-1.66; p<0.001).