Abstract 11871: Left Ventricular End Diastolic Diameter as a Predictor of Severe Functional Mitral Regurgitation Persistence Following Acute Heart Failure Hospitalization

Abstract

Introduction: The phenotype of patients with functional mitral regurgitation (fMR) is broad. We sought to study the relationship of left-ventricular end-diastolic diameter (LVIDd) with severe fMR persistence after acute heart failure hospitalization. Methods/Results: We conducted a retrospective chart review of consecutively admitted patients to Montefiore Medical Center between 2012-2017 for acute-decompensated heart-failure (ADHF) who also had a severe fMR on index transthoracic-echocardiogram (TTE), and had follow-up TTE available within 1-6 months of hospital discharge. Patients were categorized into two subgroups based on whether their follow-up TTE showed improvement in fMR severity to moderate/less vs. persistence of severe fMR and compared for baseline characteristics. Relationship between LVIDd quartiles based on LVIDd on index TTE, and rates of persistent severe fMR on follow-up TTE were also evaluated. A total of 134 patients met our study criteria, n= 53(40%) with improved fMR and n=81(60%) with persistent severe fMR on follow-up TTE. The two groups were similar including guideline-directed-medical-therapy (GDMT) and diuretic use (Table-1). Patients in the highest LVIDd quartile (≥6.4cm) were less likely to have fMR improvement on follow-up TTE than patients in the 1 st -3 rd quartiles (19% vs 46%,p=0.007, Figure 1). Conclusions: LVIDd on index TTE at time of ADHF-hospitalization was associated with severe fMR persistence post-discharge. In our cohort, LVIDd ≥6.4cm was associated with lower likelihood of improvement in severe fMR with pharmacotherapy alone, and may help to identify patients who may benefit from interventional therapies.