Abstract
Background
Mitral regurgitation is the most common form of valvular heart disease worldwide,
however, there is an incomplete understanding of predictors of mortality in this population.
This study sought to identify risk factors of mortality in a real-world population
with mitral regurgitation.
Methods
All patients with moderate or severe mitral regurgitation were identified at a single
center from January 1, 2016 to August 31, 2017. Multivariate regression was performed
to evaluate variables independently associated with all-cause mortality.
Results
A total of 490 patients with moderate (76.3%) or severe (23.7%) mitral regurgitation
due to primary (20.8%) or secondary (79.2%) etiology were identified. The mean age
was 66.7 years; 50% were male. At a median follow-up of 3.1 years, the incidence of
all-cause mortality was 30.1%, heart failure hospitalization 23.1%, and mitral valve
intervention 11.6%. Of 117 variables, multivariate analysis demonstrated 5 that were
independently predictive of mortality: baseline creatinine (hazard ratio [HR] 1.2;
95% CI, 1.0-1.3; P = .02), right atrial pressure by echocardiogram (HR 1.3; 95% CI, 1.07-1.55; P = .008), hemoglobin (HR 0.65; 95% CI, 0.52-0.83; P = .001), hospitalization for heart failure (HR 1.6; 95% CI, 1.1-2.4; P = .015), and mitral valve intervention (HR 0.40; 95% CI, 0.16-0.83; P = .049).
Conclusion
In this retrospective, pragmatic analysis of patients with moderate or severe mitral
regurgitation, admission for heart failure exacerbation, elevated right atrial pressure,
renal dysfunction, anemia, and lack of mitral valve intervention were independently
associated with increased risk of all-cause mortality. Whether these risk factors
may better identify select patients who may benefit from more intensive monitoring
or earlier intervention should be considered in future studies.
Keywords
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Article Info
Publication History
Published online: October 11, 2021
Footnotes
Funding: None.
Conflicts of Interest: LW and MS are employees of Mpirik, a health care software company. All other authors report no conflicts of interest.
Authorship: We verify that all authors had access to the data and were involved in writing the manuscript.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
