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Long-term outcomes in distinct phenogroups of patients with primary mitral regurgitation undergoing valve surgery

Soongu Kwak1,2, Seung-Ah Lee3, Jaehyun Lim1,2

  • 1Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of).

Heart (British Cardiac Society)
|July 26, 2022
PubMed
Abstract

Insights

Researchers identified five distinct patient groups with severe primary mitral regurgitation (MR). These phenogroups have different risk profiles and long-term outcomes after mitral valve surgery, aiding personalized treatment strategies.

Area of Science:

  • Cardiology
  • Medical Research
  • Patient Stratification

Background:

  • Severe primary mitral regurgitation (MR) presents heterogeneous patient profiles and varying risk levels.
  • Understanding these differences is crucial for optimizing treatment and predicting outcomes after mitral valve (MV) surgery.

Purpose of the Study:

  • To identify distinct patient phenogroups within severe primary MR.
  • To investigate the long-term prognosis of these identified phenogroups following MV surgery.

Main Methods:

  • Retrospective analysis of a large cohort of patients with severe primary MR undergoing MV surgery (derivation and validation sets).
  • Latent class analysis using 15 clinical variables to classify patients into subgroups.
  • Primary outcome assessed was all-cause mortality post-MV surgery.

Main Results:

  • Five distinct phenogroups were identified: three younger (varying comorbidities and demographics) and two older (low-risk and high-risk).
  • Significant differences in cumulative survival were observed among phenogroups, with the highest mortality in the high-risk older group (83.4% 5-year survival).
  • The identified phenogroups demonstrated comparable predictive performance to existing scores for degenerative MR.

Conclusions:

  • The study successfully delineated five phenogroups for severe primary MR patients, each with unique risk profiles and prognoses.
  • This phenogrouping approach offers a potential improvement in risk stratification for optimizing surgical timing and intervention strategies in MR patients.
Keywords:
Mitral Valve Insufficiency

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