Abstract 13177: Prognostic Significance of Functional Mitral Regurgitation in Patients Admitted With Acute Decompensated Heart Failure
Background: Functional mitral regurgitation (FMR) is known to associate with a poor prognosis in patients with chronic heart failure. FMR is also often observed in the patients admitted for acute decompensated heart failure (ADHF). However, the changes in grades of FMR after the treatments of ADHF and their impacts on the medium- to long-term prognosis are not known.
Method: Of 757 consecutive patients admitted for ADHF to National Cerebral and Cardiovascular Center during 2006-2009, 443 patients were graded FMR both at admission and discharge, and followed-up the clinical outcomes. The endpoint was a composite of all-cause death and readmission for heart failure.
Result: The patients’ age was 72±13 years old, 63% male, and average fraction shortening was 21±11%. Of 443 patients, 326 had no/mild and 117 had moderate/severe FMR at admission. After medical treatments, 366 had no/mild and 77 had moderate/severe FMR at discharge. During the follow-up period (average 2.3±1.3 years), adverse cardiac events were occurred in 146 (33%) patients. The grade of FMR at admission was not associated with the prognosis, while residual moderate/severe FMR at discharge was associated with a poor prognosis (Figure A). Logistic regression analyses adjusted with age, sex, and the serum BNP level showed that the residual moderate/severe FMR at discharge was associated with the increased risk of the development of adverse cardiac events (RR 1.56, 95% CI 1.04-2.29; p=0.03) (Figure B).
Conclusion: Remaining moderate/severe FMR after medical treatments has a negative prognostic impact in the patients admitted for ADHF and may be a potential target by the invasive treatments.
- © 2013 by American Heart Association, Inc.