Community prevalence, mechanisms and outcome of mitral or tricuspid regurgitation

Abstract

ObjectiveThe study aims were (1) to identify the community prevalence of moderate or greater mitral or tricuspid regurgitation (MR/TR), (2) to compare subjects identified by population screening with those with known valvular heart disease (VHD), (3) to understand the mechanisms of MR/TR and (4) to assess the rate of valve intervention and long-term outcome.MethodsAdults aged ≥65 years registered at seven family medicine practices in Oxfordshire, UK were screened for inclusion (n=9504). Subjects with known VHD were identified from hospital records and those without VHD invited to undergo transthoracic echocardiography (TTE) within the Oxford Valvular Heart Disease Population Study (OxVALVE). The study population ultimately comprised 4755 subjects. The severity and aetiology of MR and TR were assessed by integrated comprehensive TTE assessment.ResultsThe prevalence of moderate or greater MR and TR was 3.5% (95% CI 3.1 to 3.8) and 2.6% (95% CI 2.3 to 2.9), respectively. Primary MR was the most common aetiology (124/203, 61.1%). Almost half of cases were newly diagnosed by screening: MR 98/203 (48.3%), TR 69/155 (44.5%). Subjects diagnosed by screening were less symptomatic, more likely to have primary MR and had a lower incidence of aortic valve disease. Surgical intervention was undertaken in six subjects (2.4%) over a median follow-up of 64 months. Five-year survival was 79.8% in subjects with isolated MR, 84.8% in those with isolated TR, and 59.4% in those with combined MR and TR (p=0.0005).ConclusionsModerate or greater MR/TR is common, age-dependent and is underdiagnosed. Current rates of valve intervention are extremely low.

Heartbeat: principles for excellence in development of clinical guidelines

“…The prevalence and outcomes of adults over age 65 years with more than mild mitral regurgitation (MR) or tricuspid regurgitation (TR) was studied in 4755 subjects who had undergone echocardiography in the Oxford Valvular Heart Disease Population Study (OxVALVE). 6 Overall, the prevalence of moderate or greater MR was 3.5% and TR was 2.6% with only about half these patients having previously diagnosed valve disease. Subjects with regurgitation identified by screening were less likely to be symptomatic than those with known valve disease.…”

Transcatheter Treatment of Mitral Regurgitation

“…Although the prevalence varies across countries, native mitral valve (MV) disease is the second most common valvular heart disease (VHD) in Europe [ 1 , 2 ]. Mitral regurgitation (MR) remains the most common disease of the MV with primary, degenerative MR, due to dysfunction of any of the components of the MV, being more common than secondary or functional MR caused by changes in the geometry of the left ventricle or left atrium.…”

Demonstration of Use of a Novel 3D Printed Simulator for Mitral Valve Transcatheter Edge-to-Edge Repair (TEER)

“…Mitral valve (MV) disorders are the most prevalent heart valve disease and the second most frequent condition requiring cardiac surgery [1][2][3][4]. Mitral regurgitation (MR) is the predominant heart valve disease in developed countries, found in 1.7% of the adult population [3,5]. It occurs due to the inability of the valvular leaflets to completely close during ventricular contraction.…”