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Survival in Patients with Degenerative Mitral Stenosis: Results from a Large Retrospective Cohort Study

Ioana Pasca1, Patricia Dang2, Gaurav Tyagi2

  • 1Division of Anesthesiology, Loma Linda University Medical Center, Loma Linda, California.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|March 4, 2016
PubMed

Insights

Survival for patients with severe mitral annular calcification causing degenerative mitral stenosis (DMS) is poor. Age, renal insufficiency, atrial fibrillation, and other valve issues worsen prognosis, while certain medications may improve survival.

Area of Science:

  • Cardiology
  • Valvular Heart Disease
  • Echocardiography

Background:

  • Severe mitral annular calcification (MAC) causing degenerative mitral stenosis (DMS) is a growing concern in valve intervention patients.
  • The clinical profile, natural history, and survival factors in DMS patients are not well-understood.

Purpose of the Study:

  • To characterize factors influencing survival in patients diagnosed with degenerative mitral stenosis (DMS).

Main Methods:

  • A cohort of 1,004 patients with DMS was identified from an institutional echocardiographic database.
  • Survival analysis was performed using clinical, pharmacologic, and echocardiographic variables.

Main Results:

  • 1- and 5-year survival rates were 78% and 47%, respectively, with worse outcomes in higher DMS grades.
  • Risk factors for mortality included older age, atrial fibrillation, renal insufficiency, mitral/tricuspid regurgitation, elevated right atrial pressure, aortic stenosis, and low albumin.
  • Renin-angiotensin system blockers and statins were associated with better survival; digoxin use correlated with higher mortality.

Conclusions:

  • Prognosis for DMS patients is poor, particularly in the elderly and those with comorbidities like renal insufficiency and atrial fibrillation.
  • Concomitant valvular lesions also negatively impact survival.
  • Renin-angiotensin system blockers and statins may offer survival benefits, while digoxin use warrants caution.
Abstract

Keywords:
DegenerativeMitral annular calcificationMitral stenosisSurvival

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