Article ; Online: Quantified mitral regurgitation and left atrial function in heart failure with reduced ejection fraction: interplay and outcome implications.
European journal of heart failure
2022 Volume 24, Issue 4, Page(s) 694–702
Abstract: Aims: The clinical and prognostic importance of functional mitral regurgitation (FMR) in heart failure patients with reduced ejection fraction (HFrEF) has been highly debated. This study aims to define FMR linkage to cardiovascular (CV) outcomes and the ...
Abstract | Aims: The clinical and prognostic importance of functional mitral regurgitation (FMR) in heart failure patients with reduced ejection fraction (HFrEF) has been highly debated. This study aims to define FMR linkage to cardiovascular (CV) outcomes and the interplay with left atrial (LA) function in a prospective cohort of consecutive HFrEF outpatients. Methods and results: Overall, 286 consecutive outpatients with chronic HFrEF were prospectively enrolled. FMR was quantified by effective regurgitant orifice area (EROA). Global peak atrial longitudinal strain (PALS) was measured by speckle tracking echocardiography. The primary endpoint was a composite of congestive heart failure hospitalization or CV death. During a mean follow-up of 4.1 ± 1.5 years, the primary endpoint occurred in 99 patients (35%). The spline modelling of the risk by FMR severity showed an excess event risk starting at about the EROA value of 0.1 cm Conclusions: Our results refine the independent association between FMR and CV outcome among HFrEF outpatients. Within a moderate EROA range, LA function mitigates the clinical consequences of mitral regurgitation, providing measurable proof of the interplay between regurgitation and LA compliance. |
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MeSH term(s) | Atrial Function, Left ; Heart Atria/diagnostic imaging ; Heart Failure/epidemiology ; Humans ; Mitral Valve Insufficiency/epidemiology ; Prospective Studies ; Stroke Volume ; Ventricular Function, Left |
Language | English |
Publishing date | 2022-01-26 |
Publishing country | England |
Document type | Journal Article |
ZDB-ID | 1483672-5 |
ISSN | 1879-0844 ; 1388-9842 |
ISSN (online) | 1879-0844 |
ISSN | 1388-9842 |
DOI | 10.1002/ejhf.2429 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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