Abstract 3551: Impact of Mitral Valve Tenting in the Long-Term Prognosis of Decompensated Heart Failure
Background: Functional mitral regurgitation (FMR) is a sinister prognostic predictor in patients with ischemic heart disease. Mitral valve (MV) tenting area by 2D echo is widely used to assess the degree of MV tethering, which is known to be a main mechanism of FMR. However, the influence of FMR and MV tenting area over the long-term prognosis in decompensated heart failure is unclear. We investigated the degree of FMR and MV tenting as predictors of long-term prognosis in decompensated heart failure with their dynamic changes during intensive therapy.
Methods: 40 patients who admitted to our hospital for exacerbation of congestive heart failure (CHF) symptoms from 2002 to 2004 were studied. 2D echo exam was performed at the timing of admission and discharge. Patients were divided into two groups; Group A, 21 patients who showed an improvement of tenting area during the therapy; Group B, 19 patients who didn’t show an improvement of tenting area during the therapy. The long-term event rates of CHF and/or cardiac death were evaluated in both groups. Average follow-up period was 803±461days.
Results: Cardiac death free survival rate was significantly lower in group B than in group A (Log-rank, p<0.014, Figure 1⇓). Incidence of recurrent CHF was also significantly higher in group B compared with group A (p<0.01, Figure 2⇓). Average time to CHF after discharge was 804days in group A and 474days in group B. Changes of MR degree during the therapy did not have significant impact for the long-term prognosis in the studied population.
Conclusion: Improvement of MV tenting area during intensive therapy is a strong predictive factor in the long-term prognosis of decompensate heart failure.