BACKGROUND: Functional mitral regurgitation (FMR) is a common complication of heart failure (HF) and worsens in acute decompensation. It is unclear whether FMR on admission or discharge determines the outcome. This study aimed to elucidate the prognostic significance of FMR on admission or discharge in patients admitted with acute decompensated HF. METHODS AND RESULTS: From 2006 to 2009, 349 patients admitted with acute decompensated HF were enrolled. They were followed with the composite endpoint of all-cause death and hospitalization for HF; 74 (21%) died and 113 (32%) developed the composite endpoint during 2.1±1.3 years. Moderate/severe FMR at discharge was associated with the composite endpoint (P=0.001), whereas that on admission was not. Multivariate Cox proportional hazard analysis showed that moderate/severe FMR (hazard ratio [95% confidence interval] =1.70 [1.03-2.73] P=0.04), logBNP, and NYHA class III/IV at discharge were independent determinants of the outcome. Moderate/severe FMR at discharge with BNP ≥200 pg/ml was prognostic, but BNP <200 pg/ml was no longer prognostic. CONCLUSIONS: Residual moderate/severe FMR after medical therapy for acute decompensated HF was associated with poor outcome, suggesting a potential target for further treatment of HF.
BACKGROUND:Functional mitral regurgitation (FMR) is a common complication of heart failure (HF) and worsens in acute decompensation. It is unclear whether FMR on admission or discharge determines the outcome. This study aimed to elucidate the prognostic significance of FMR on admission or discharge in patients admitted with acute decompensated HF. METHODS AND RESULTS: From 2006 to 2009, 349 patients admitted with acute decompensated HF were enrolled. They were followed with the composite endpoint of all-cause death and hospitalization for HF; 74 (21%) died and 113 (32%) developed the composite endpoint during 2.1±1.3 years. Moderate/severe FMR at discharge was associated with the composite endpoint (P=0.001), whereas that on admission was not. Multivariate Cox proportional hazard analysis showed that moderate/severe FMR (hazard ratio [95% confidence interval] =1.70 [1.03-2.73] P=0.04), logBNP, and NYHA class III/IV at discharge were independent determinants of the outcome. Moderate/severe FMR at discharge with BNP ≥200 pg/ml was prognostic, but BNP <200 pg/ml was no longer prognostic. CONCLUSIONS: Residual moderate/severe FMR after medical therapy for acute decompensated HF was associated with poor outcome, suggesting a potential target for further treatment of HF.
Authors: Jessica H Huston; Robinson Ferre; Peter S Pang; Ovidiu Chioncel; Javed Butler; Sean Collins Journal: Am J Ther Date: 2018 Jul/Aug Impact factor: 2.688
Authors: Sameer Arora; Krishan Sivaraj; Michael Hendrickson; Patricia P Chang; Thelsa Weickert; Arman Qamar; Muthiah Vaduganathan; Melissa C Caughey; Ambarish Pandey; Matthew A Cavender; Wayne Rosamond; John P Vavalle Journal: JACC Heart Fail Date: 2020-12-09 Impact factor: 12.035
Authors: Matteo Pagnesi; Marianna Adamo; Iziah E Sama; Stefan D Anker; John G Cleland; Kenneth Dickstein; Gerasimos S Filippatos; Riccardo M Inciardi; Chim C Lang; Carlo M Lombardi; Leong L Ng; Piotr Ponikowski; Nilesh J Samani; Faiez Zannad; Dirk J van Veldhuisen; Adriaan A Voors; Marco Metra Journal: Clin Res Cardiol Date: 2022-03-16 Impact factor: 6.138
Authors: Matteo Pagnesi; Marianna Adamo; Iziah E Sama; Stefan D Anker; John G Cleland; Kenneth Dickstein; Gerasimos S Filippatos; Chim C Lang; Leong L Ng; Piotr Ponikowski; Alice Ravera; Nilesh J Samani; Faiez Zannad; Dirk J van Veldhuisen; Adriaan A Voors; Marco Metra Journal: Eur J Heart Fail Date: 2021-08-01 Impact factor: 17.349