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Dilated cardiomyopathy with mitral regurgitation: decreased survival despite a low frequency of left ventricular

D S Blondheim1, L E Jacobs, M N Kotler

  • 1Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA.

American Heart Journal
|September 1, 1991
PubMed

Insights

Mitral regurgitation (MR) in dilated cardiomyopathy patients is linked to fewer left ventricular thrombi but significantly reduced survival rates. This finding highlights MR as a key indicator of poor prognosis.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Research

Background:

  • Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
  • Left ventricular thrombi (LVT) are a known complication of DCM, increasing embolic risk.
  • Mitral regurgitation (MR) is common in DCM, but its prognostic implications require further elucidation.

Purpose of the Study:

  • To investigate the relationship between mitral regurgitation (MR) and left ventricular thrombi (LVT) in patients with dilated cardiomyopathy (DCM).
  • To assess the impact of MR on apical flow velocities and survival in DCM patients.
  • To determine if MR can serve as a noninvasive marker for prognosis in DCM.

Main Methods:

  • Echocardiography (2D, pulsed, and color Doppler) was used in 91 DCM patients.
  • Assessment included quantification of MR, measurement of apical flow velocities, and detection of LVT.
  • Follow-up data was collected to evaluate patient survival.

Main Results:

  • MR was detected in 57% of patients; LVT in 40%.
  • The co-occurrence of MR and LVT was infrequent (8%).
  • Patients with MR exhibited significantly higher apical flow velocities and markedly decreased survival rates (22% vs. 60% at 32 months).

Conclusions:

  • Mitral regurgitation in DCM is associated with reduced left ventricular thrombus formation.
  • MR is a sensitive, noninvasive marker indicating significantly decreased survival in dilated cardiomyopathy.
  • Even mild MR portends a worse prognosis in DCM patients.

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