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Prognostic implications of functional mitral regurgitation according to the severity of the underlying chronic heart

Francesca Bursi1, Andrea Barbieri, Francesco Grigioni

  • 1Institute of Cardiology, Policlinico University Hospital, Via del Pozzo 71, Modena, Italy. bursi.francesca@mayo.edu

European Journal of Heart Failure
|March 4, 2010
PubMed

Insights

Functional mitral regurgitation (FMR) significantly impacts survival in less severe chronic heart failure (CHF) patients, indicating a need for targeted interventions in early-stage disease.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Valvular Heart Disease

Background:

  • Functional mitral regurgitation (FMR) is common in patients with chronic heart failure (CHF).
  • Previous studies have yielded conflicting results regarding the prognostic significance of FMR in CHF.

Purpose of the Study:

  • To investigate the independent prognostic value of FMR.
  • To assess the impact of FMR severity on outcomes in systolic CHF outpatients.

Main Methods:

  • Echocardiography to assess FMR severity in 469 CHF patients.
  • Long-term follow-up for death and heart transplantation.
  • Multivariable adjustment and propensity score analysis.

Main Results:

  • A significant graded association exists between FMR severity and increased risk of death/transplant (P < 0.0001).
  • FMR was an independent predictor of adverse events in less severe CHF and lower-risk patients.
  • The association was not significant in advanced CHF or high-risk subgroups.

Conclusions:

  • FMR is an independent predictor of mortality and heart transplantation specifically in patients with less severe CHF and lower risk profiles.
  • FMR plays a critical role in the early stages of CHF.
  • Intervention strategies targeting FMR should focus on patients in the earlier phases of the disease.
Abstract

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