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Functional mitral regurgitation predicts 1‐year mortality in elderly patients with systolic chronic heart failure
Author(s) -
Cioffi Giovanni,
Tarantini Luigi,
De Feo Stefania,
Pulignano Giovanni,
Del Sindaco Donatella,
Stefenelli Carlo,
Di Lenarda Andrea,
Opasich Cristina
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.01.016
Subject(s) - medicine , heart failure , cardiology , ejection fraction , mitral regurgitation , diabetes mellitus , logistic regression , diastole , blood pressure , endocrinology
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.