Degenerative mitral stenosis by echocardiography: presentation and outcome

Area of Science:

• Cardiology
• Echocardiography
• Geriatric Medicine

Background:

• Degenerative mitral stenosis (DMS) arises from mitral annular and valvular calcification.
• The impact of DMS on patient outcomes and treatment needs remains poorly understood.
• DMS affects elderly individuals, often presenting with comorbidities.

Purpose of the Study:

• To evaluate the survival rates of patients diagnosed with degenerative mitral stenosis using Doppler echocardiography in routine clinical practice.
• To identify factors influencing short- and long-term mortality in patients with DMS.

Main Methods:

• A cohort of 2937 patients diagnosed with DMS between 2003 and 2014 was analyzed.
• Echocardiography was used to assess DMS severity, left atrial size, and pulmonary pressures.
• Survival analysis was performed, considering comorbidities, anemia, and DMS severity.

Main Results:

• One-year mortality was 22%, strongly linked to age, comorbidity, and abnormal hemoglobin/creatinine levels.
• Long-term mortality reached 56% at 5 years, primarily associated with aging and comorbidities.
• DMS severity was a weak, though independent, determinant of mortality, particularly in patients without anemia.

Conclusions:

• DMS is a condition in the elderly associated with significant mortality, largely driven by comorbidities.
• While DMS can cause severe mitral obstruction, its severity is a less critical predictor of mortality than comorbidities and anemia.
• Careful patient evaluation and selective consideration of interventional or surgical treatment are recommended for patients with DMS, especially those without anemia.