Abstract
To examine the independent prognostic role of functional mitral regurgitation (FMR) and its impact across the severity of chronic heart failure (CHF) in a large population of outpatients with systolic CHF followed at two multidisciplinary clinics. Echocardiography was performed upon enrolment in 469 CHF patients. Follow-up for death and heart transplant was updated on January 2007. Five-year transplant-free survival was 82.7% in patients with no or Grade I FMR, 64.4% in Grade II, 58.5% in Grade III, and 46.5% in Grade IV (P < 0.0001). There was a strong graded association between FMR and the long-term risk of death and heart transplant, which remained significant after multivariable adjustment (P = 0.0003). The association between FMR and events was strong and independent in patients with less severe symptoms and in those at lower overall risk based on a propensity score analysis, while it was not significant in patients with more advanced CHF or in the high-risk subgroup (P < 0.0001 for interactions). This study clarifies previous apparently discrepant results by demonstrating that FMR is an independent determinant of death and heart transplantation only in less severe CHF and in patients with a lower risk profile. This finding indicates that FMR plays a major role in the early phase of CHF, suggesting that this should be the focus of strategies attempting to reduce it.
Highlights
Functional mitral regurgitation (FMR), due to left ventricular and annular dysfunction in the absence of organic lesions, is frequent in patients with chronic heart failure (CHF).[1]
No available study has systematically examined the role of FMR across the whole spectrum of CHF and among patients managed at dedicated multidisciplinary outpatient clinics, where patients are uniformly followed by a dedicated team according to the most updated guidelines.[8]
The aim of the present study was to examine the independent prognostic role of FMR and to evaluate its impact across the severity of CHF in a large population of outpatients with CHF and systolic left ventricular (LV) dysfunction followed at two multidisciplinary CHF outpatient clinics
Summary
Functional mitral regurgitation (FMR), due to left ventricular and annular dysfunction in the absence of organic lesions, is frequent in patients with chronic heart failure (CHF).[1]. No available study has systematically examined the role of FMR across the whole spectrum of CHF and among patients managed at dedicated multidisciplinary outpatient clinics, where patients are uniformly followed by a dedicated team according to the most updated guidelines.[8]. The aim of the present study was to examine the independent prognostic role of FMR and to evaluate its impact across the severity of CHF in a large population of outpatients with CHF and systolic left ventricular (LV) dysfunction followed at two multidisciplinary CHF outpatient clinics
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
