SEVERITY OF MITRAL REGURGITATION AND ITS ASSOCIATION WITH LEFT VENTRICULAR DYSFUNCTION AND BRAIN-NATRIURETIC PEPTIDE...

Acute decompensated heart failure (ADHF) is greatly influenced by levels of brain-natriuretic peptides (BNP) and thereby may have strong correlation with severity of mitral regurgitation (MR) and left ventricular ejection fraction (LVEF). The available data on its association is limited which sought us to investigate correlations between type of ADHF, BNP levels and severity of MR. A single-center, cross-sectional, observational study was conducted at Sri Ramachandra Institute of Higher Education and Research, Chennai, India. Adults aged >18 years, either gender, diagnosed as ADHF requiring hospital admission within 24 hours were incorporated into the research.Between June 2019 to June 2020, we included 79 patients of ADHF. The mean age was 64.9±11 years and 60.8% were males. The mean LVEF was 40.2±10.2%. The severity of MR was severe, moderate, and mild in 3.8%, 21.5% and 74.7% of patients, respectively. The proportion of patients with moderate to severe MR was significantly higher in ADHF patients with reduced EF compared to mid-range or preserved EF. The median levels of BNP significantly increased from 520.0 pg/ml in mild MR to 1020.0 pg/ml in moderate and 1410.0 pg/ml in severe MR. In patients with ADHF, MR is a common finding. The severity of MR is associated with greater reduction in ejection fraction. Determination of MR severity is essential in all ADHF cases. Further, stratification of patients using BNP levels may help in identifying those at higher risk of adverse outcomes in ADHF.