Prognostic role of mitral regurgitation in patients with advanced heart failure
Copyright © 2023. Published by Elsevier B.V..
AIM: The impact of mitral regurgitation (MR) in patients with advanced heart failure (HF) is poorly known. We aimed to evaluate the impact of MR on clinical outcomes of a real-world, contemporary, multicentre population with advanced HF.
METHODS: The HELP-HF registry enrolled patients with HF and at least one "I NEED HELP" criterion, at four Italian centres between January 2020 and November 2021. The population was stratified by none/mild MR vs. moderate MR vs. severe MR. Outcomes of interest were all-cause, cardiovascular (CV) death, the composite of all-cause death or first HF hospitalization, first HF hospitalization and recurrent HF hospitalizations.
RESULTS: Among 1079 patients, 429 (39.8%) had none/mild MR, 443 (41.1%) had moderate MR and 207 (19.2%) had severe MR. Patients with severe MR were most likely to be inpatients, present with cardiogenic shock, need intravenous loop diuretics and inotropes/vasopressors, have lower ejection fraction and higher natriuretic peptides. Estimated rates of all-cause death, CV death, and the composite of all-cause death or first HF hospitalization at 1 year increased with increasing MR severity. Compared with no/mild MR, severe MR was independently associated with an increased risk of CV death (adjusted HR 1.61, 95% CI 1.04-2.51, p = 0.033) and recurrent HF hospitalizations (adjusted HR 1.49, 95% CI 1.08-2.06, p = 0.015), but not with and increased risk of all-cause death, first HF hospitalization and composite outcome.
CONCLUSIONS: In unselected patients with advanced HF, severe MR was common and independently associated with an increased risk of CV death and of recurrent HF hospitalizations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:122 |
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| Enthalten in: |
European journal of internal medicine - 122(2024) vom: 15. Apr., Seite 102-108 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pagnesi, Matteo [VerfasserIn] |
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| Links: |
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| Themen: |
Advanced heart failure |
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| Anmerkungen: |
Date Completed 08.04.2024 Date Revised 08.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejim.2023.11.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364717645 |
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| 245 | 1 | 0 | |a Prognostic role of mitral regurgitation in patients with advanced heart failure |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 08.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier B.V. | ||
| 520 | |a AIM: The impact of mitral regurgitation (MR) in patients with advanced heart failure (HF) is poorly known. We aimed to evaluate the impact of MR on clinical outcomes of a real-world, contemporary, multicentre population with advanced HF | ||
| 520 | |a METHODS: The HELP-HF registry enrolled patients with HF and at least one "I NEED HELP" criterion, at four Italian centres between January 2020 and November 2021. The population was stratified by none/mild MR vs. moderate MR vs. severe MR. Outcomes of interest were all-cause, cardiovascular (CV) death, the composite of all-cause death or first HF hospitalization, first HF hospitalization and recurrent HF hospitalizations | ||
| 520 | |a RESULTS: Among 1079 patients, 429 (39.8%) had none/mild MR, 443 (41.1%) had moderate MR and 207 (19.2%) had severe MR. Patients with severe MR were most likely to be inpatients, present with cardiogenic shock, need intravenous loop diuretics and inotropes/vasopressors, have lower ejection fraction and higher natriuretic peptides. Estimated rates of all-cause death, CV death, and the composite of all-cause death or first HF hospitalization at 1 year increased with increasing MR severity. Compared with no/mild MR, severe MR was independently associated with an increased risk of CV death (adjusted HR 1.61, 95% CI 1.04-2.51, p = 0.033) and recurrent HF hospitalizations (adjusted HR 1.49, 95% CI 1.08-2.06, p = 0.015), but not with and increased risk of all-cause death, first HF hospitalization and composite outcome | ||
| 520 | |a CONCLUSIONS: In unselected patients with advanced HF, severe MR was common and independently associated with an increased risk of CV death and of recurrent HF hospitalizations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Advanced heart failure | |
| 650 | 4 | |a Clinical outcomes | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Hospitalization | |
| 650 | 4 | |a Mitral regurgitation | |
| 650 | 4 | |a Mortality | |
| 700 | 1 | |a Calì, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Chiarito, Mauro |e verfasserin |4 aut | |
| 700 | 1 | |a Stolfo, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a Baldetti, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Lombardi, Carlo M |e verfasserin |4 aut | |
| 700 | 1 | |a Tomasoni, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Loiacono, Ferdinando |e verfasserin |4 aut | |
| 700 | 1 | |a Maccallini, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Villaschi, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Cocianni, Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Perotto, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Voors, Adriaan A |e verfasserin |4 aut | |
| 700 | 1 | |a Pini, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Metra, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Adamo, Marianna |e verfasserin |4 aut | |
| 700 | 0 | |a HELP-HF Registry investigators |e verfasserin |4 aut | |
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