A Unifying Concept for the Quantitative Assessment of Secondary Mitral Regurgitation

Bartko, Philipp E.; Arfsten, Henrike; Heitzinger, Gregor; Pávó, Noémi; Toma, Aurel; Strunk, Guido; Hengstenberg, Christian; Hülsmann, Martin

doi:10.1016/j.jacc.2019.02.075

Cited by 91 publications

(67 citation statements)

References 19 publications

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“…The univariable and multivariable logistic regression analysis were performed to determine the characteristics that were independently associated with in-hospital mortality. The effective sample size is too small the stepwise bootstrap-adjusted analysis including all variables was used to identify best-fitting variables for the final multivariable Cox- regression model [33,34,35]. Clinical, microbiological, and echocardiographic variables found to be significantly associated with mortality in a univariate analysis ( p < 0.1) were included in the multivariable logistic regression analysis and bootstrap -adjusted analysis.…”

Section: Methodsmentioning

confidence: 99%

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Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

Lin

Chua

Chung

et al. 2019

IJERPH

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Infective endocarditis (IE) is a severe disease with a hospital mortality rate of 17%–25%. Early identification of IE patients with high risk of mortality may improve their clinical outcomes. Patients with diabetes mellitus (DM) who develop infective diseases are associated with worse outcomes. This study aimed to define the impact of DM on long-term mortality in IE patients. A total of 412 patients with definite IE from February 1999 to June 2012 were enrolled in this observational study and divided into 2 groups: group 1, patients with DM (n = 72) and group 2, patients without DM (n = 340). The overall in-hospital mortality rate for both groups combined was 20.2% and was higher in group 1 than in group 2 (41.7% vs. 16.5%, p < 0.01). Compared to patients without DM, patients with DM were older and associated with higher incidence of chronic diseases, less drug abuse, higher creatinine levels, and increased risk of Staphylococcus aureus infection (all p < 0.05). Moreover, they were more likely to have atypical clinical presentation and were associated with longer IE diagnosis time (all p < 0.05). In multivariable analysis, DM is an independent and significant predictor of mortality. The prognosis of IE patients with DM is still poor. Early identification and more aggressive treatment may be considered in IE patients with DM.

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Section: Methodsmentioning

confidence: 99%

“…This is barely large enough to include 6-degrees-of-freedom worth of variables in consideration. Although the bootstrap-based variance adjustment [33,34,35] was used to alleviate some bias, this method can’t completely eliminate all bias.…”

Section: Study Limitationsmentioning

confidence: 99%

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

Lin

Chua

Chung

et al. 2019

IJERPH

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“…This will provide the opportunity to study combined criteria of regurgitation severity, which improve risk stratification in patients with secondary mitral regurgitation. 26 Several expert-reviews have suggested to take into account the respective severity of mitral regurgitation and left ventricular remodelling, but this has not been specifically studied in patients undergoing interventions on the mitral valve. 11,27,28 The usefulness of such a multifactorial approach to refine the selection of patients with secondary mitral regurgitation should be the subject of further analyses.…”

confidence: 99%

Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years

Iung

Armoiry

Vahanian

et al. 2019

European J of Heart Fail

181

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et al.. Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years Methods and results. AimsThe MITRA-FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline-directed medical treatment alone.At 37 centres, we randomly assigned 304 symptomatic heart failure patients with severe secondary mitral regurgitation (effective regurgitant orifice area >20 mm 2 or regurgitant volume >30 mL), and left ventricular ejection fraction between 15% and 40% to undergo percutaneous valve repair plus medical treatment (intervention group, n = 152) or medical treatment alone (control group, n = 152). The primary efficacy outcome was the composite of all-cause death and unplanned hospitalization for heart failure at 12 months. At 24 months, all-cause death and unplanned hospitalization for heart failure occurred in 63.8% of patients (97/152) in the intervention group and 67.1% (102/152) in the control group [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.77-1.34]. All-cause *Corresponding author. Hôpital Cardiovasculaire Louis Pradel, Chirurgie Cardio-Vasculaire et Transplantation Cardiaque, mortality occurred in 34.9% of patients (53/152) in the intervention group and 34.2% (52/152) in the control group (HR 1.02, 95% CI 0.70-1.50). Unplanned hospitalization for heart failure occurred in 55.9% of patients (85/152) in the intervention group and 61.8% (94/152) in the control group (HR 0.97, 95% CI 0.72-1.

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“…Ventricles of different volumes can have similar EROAs but different RVol and RF. ASE and EACVI guidelines consider different thresholds to discriminate severe MR. An algorithm for quantitative assessment of FMR based on estimation of RF has been proposed to further stratify the patients among those within the grey area (EROA of 20-30 mm 2 and a RVol of 30-44 mL), identifying patients with RF > 50% those at high risk [11] .…”

Section: Echocardiographymentioning

confidence: 99%

Multimodality imaging for preprocedural planning of percutaneous mitral valve repair: a comprehensive review

Melillo¹,

Boccellino²,

Ingallina³

et al. 2020

Mini-invasive Surg

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New transcatheter mitral valve (MV) therapies are now available as alternatives to surgical and medical treatments in patients at high or prohibitive operative risk. Multimodality imaging including echocardiography, cardiac magnetic resonance, and cardiac computed tomography provide complementary information to guide patient and device selection. Morphology and functional anatomy of the MV should be carefully evaluated to determine the feasibility of percutaneous treatment; to identify the best therapeutic approach, either leaflet or annulus or combined; and to predict the probability of procedural success that is crucial for subsequent outcome and should be integrated by comprehensive preprocedural assessment of chamber size, biventricular systolic and diastolic function, valvopathy hemodynamic impact and aortic or peripheral vascular disease. The spectrum of transcatheter options is now wide and encompasses leaflet repair, direct or indirect annuloplasty, and cordal implantation. The aim of this review is to provide an overview on the role of multimodality imaging in the patient selection and preprocedural planning of percutaneous mitral valve repair.

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A Unifying Concept for the Quantitative Assessment of Secondary Mitral Regurgitation

Cited by 91 publications

References 19 publications

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years

Multimodality imaging for preprocedural planning of percutaneous mitral valve repair: a comprehensive review

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