Prognostic Implications of Functional Mitral Regurgitation in Patients With Heart Failure and Reduced Ejection Fraction

Carmena, María Dolores García-Cosío; Minguell, Eulalia Roig; Ferrero‐Gregori, Andreu; García, Rafael Vázquez; Delgado-Jiménez, Juan; Cinca, Juan

doi:10.1016/j.rec.2016.12.033

Cited by 4 publications

(7 citation statements)

References 6 publications

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“…The initial literature search identified 3820 articles, of which 87 were retrieved for more detailed evaluation, and 53 trials (1.4%) were finally included in the study, enrolling 45 900 patients (Figure 1 and eTable 1 in the Supplement). The mean (SD) length of follow-up in our study population was 40.8 (22.2) months.…”

Section: Resultsmentioning

confidence: 99%

Survival and Cardiovascular Outcomes of Patients With Secondary Mitral Regurgitation

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Survival and Cardiovascular Outcomes of Patients With Secondary Mitral Regurgitation

et al. 2017

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“…1) Among patients with severe functional MR who remain symptomatic and have significant MR after optimization of medical treatment and resynchronization therapy (when this is indicated), surgery for the repair or replacement of the mitral valve is a therapeutic option, particularly for cases of an ischemic etiology with left ventricular ejection fraction (LVEF) >30% who will undergo coronary artery bypass graft (indication I-C). [2][3][4][5][6] Despite performance of repair surgery on the mitral valve, different studies report considerable heterogeneity in the high recurrence rate of MR in follow-up (ranging from 20.3% and 27.6% at 5 and 10 years, respectively, in Petrus et al 7) to rates as high as 55%-70% at 10 years. 8) ) Moreover, no significant impact on long-term survival after surgery for mitral repair in functional MR has been established.…”

Section: Introductionmentioning

confidence: 99%

“…Among patients with severe functional MR who remain symptomatic and have significant MR after optimization of medical treatment and resynchronization therapy (when this is indicated), surgery for the repair or replacement of the mitral valve is a therapeutic option, particularly for cases of an ischemic etiology with left ventricular ejection fraction (LVEF) >30% who will undergo coronary artery bypass graft (indication I-C). 2 – 6)…”

Section: Introductionmentioning

confidence: 99%

Prognosis for Mitral Valve Repair Surgery in Functional Mitral Regurgitation

Campos-Arjona

Rodríguez-Capitán

Martínez-Carmona

et al. 2022

ATCS

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Purpose: Our aim was to evaluate the development of new significant mitral regurgitation and long-term survival after mitral repair surgery in functional mitral regurgitation. Methods: A retrospective observational analysis of the recurrence of functional mitral regurgitation (ischemic and nonischemic) and global mortality during follow-up of 176 patients who underwent mitral repair surgery between 1999 and 2018 in our center was conducted. Results: The etiology of functional mitral regurgitation was ischemic in 55.7% of cases. After surgery, mitral regurgitation was 0-I in 92.3% of cases. We conducted a long-term clinical follow-up of a mean 42.2 months and an echocardiographic follow-up of a mean 41.8 months. We observed mitral regurgitation of at least grade II in 52 patients (36.9%). Survival at 1, 3, and 5 years was 78.8%, 66.7%, and 52.3%, respectively. Predictive factors for global mortality were age (hazard ratio = 1.038, p = 0.01) and a depressed preoperative ejection fraction. After a competing risk analysis, we found the only predictive factor for the recurrence of mitral regurgitation in our series to be age (sub-hazard ratio = 1.03, 95% confidence interval = 1.01-1.06, p = 0.016). Conclusion: Repair surgery for functional mitral regurgitation shows age as the only independent predictor of recurrence. Age and depressed ejection fraction were predictors of mortality.

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“…The presence of significant FMR in heart failure patients has been associated with increased morbidity and mortality [ 16 , 17 , 18 ]. Although correction through percutaneous repair can improve survival significantly, the greatest controversy remains around the time of the intervention.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Mitral Repair for Functional Mitral Regurgitation According to Left Ventricular Function: A Real-Life Propensity-Score Matched Study

Pascual

Carrasco-Chinchilla

Benito‐González

et al. 2020

JCM

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Background: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip® between two groups according to LVEF. Methods: In an observational registry study, we compared the outcomes in patients with FMR who underwent TMVR with and without LVEF <30%. The primary endpoint was the combined one-year all-cause mortality and unplanned hospital readmissions due to HF. The secondary end-points were New York Heart Association (NYHA) functional class and mitral regurgitation (MR) severity. Propensity-score matching was used to create two groups with the same baseline characteristics, except for baseline LVEF. Results: Among 535 FMR eligible patients, 144 patients with LVEF <30% (group 1) and 144 with LVEF >30% (group 2) had similar propensity scores and were included in the analyses. The primary study endpoint was significantlly higher in group 1 (33.3% vs. 9.4%, p = 0.002). There was a maintained improvement in secondary endpoints without significant differences among groups. Conclusion: FMR patients with LVEF <30% treated with MitraClip® had higher mortality and readmissions than patients with LVEF ≥30% treated with the same device. However, both groups improved the NYHA functional class and MR severity.

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Prognostic Implications of Functional Mitral Regurgitation in Patients With Heart Failure and Reduced Ejection Fraction

Cited by 4 publications

References 6 publications

Survival and Cardiovascular Outcomes of Patients With Secondary Mitral Regurgitation

Survival and Cardiovascular Outcomes of Patients With Secondary Mitral Regurgitation

Prognosis for Mitral Valve Repair Surgery in Functional Mitral Regurgitation

Transcatheter Mitral Repair for Functional Mitral Regurgitation According to Left Ventricular Function: A Real-Life Propensity-Score Matched Study

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