PMID- 27547425
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160822
LR  - 20210112
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 3
IP  - 2
DP  - 2016
TI  - Echo-Doppler determinants of outcomes in patients with unoperated significant 
      mitral regurgitation in current era.
PG  - e000378
LID - 10.1136/openhrt-2015-000378 [doi]
LID - e000378
AB  - OBJECTIVE: One-half of patients with severe symptomatic mitral regurgitation (MR) 
      do not undergo surgery due to comorbidities. We evaluated prognosticators of 
      outcomes in patients with unoperated significant MR. METHODS: In this 
      observational study, we retrospectively evaluated medical records of 75 
      consecutive patients with unoperated significant MR. RESULTS: All-cause mortality 
      was 39% at 5 years. Non-survivors (n=29) versus survivors (n=46) were: older 
      (77+/-9.8 vs 68+/-14, p=0.006), had higher New York Heart Association (NYHA) class 
      (2.7+/-0.8 vs 2.3+/-0.8, p=0.037), higher brain natriuretic peptide (1157+/-717 vs 
      427+/-502 pg/mL, p=0.024, n=18), more coronary artery disease (61% vs 35%, 
      p=0.031), more frequent left ventricular ejection fraction <50% (20.7% vs 4.3%, 
      p=0.026), more functional MR (41% vs 22%, p=0.069), higher mitral E/E(') 
      (12.7+/-4.6 vs 9.8+/-4, p=0.008), higher pulmonary artery systolic pressure (PASP; 
      52.6+/-18.7 vs 36.7+/-14, p <0.001), more >/=3+ tricuspid regurgitation (28% vs 4%, 
      p=0.005) and more right ventricular dysfunction (26% vs 6%, p=0.035). Significant 
      predictors of 5-year mortality were PASP (p=0.001) and E/E(') (p=0.011) using 
      multivariate regression analysis. CONCLUSIONS: Patients with unoperated 
      significant MR have high mortality. Elevated PASP and mitral E/E(') were the most 
      significant predictors of 5-year survival in patients with unoperated significant 
      MR. Current American College of Cardiology (ACC)/American Heart Association (AHA) 
      guidelines provide a limited incorporation of echo-Doppler parameters in the 
      preoperative risk stratification of patients with severe MR.
FAU - Rafique, Asim M
AU  - Rafique AM
AD  - UCLA Medical Center , Los Angeles, California , USA.
FAU - Zarrini, Parham
AU  - Zarrini P
AD  - Cedars-Sinai Heart Institute , Los Angeles, California , USA.
FAU - Singh, Nirmal
AU  - Singh N
AD  - University of Arizona , Tucson, Arizona , USA.
FAU - Beigel, Roy
AU  - Beigel R
AD  - Sheba-Tel Hashomer Hospital , Ramat Gan , Israel.
FAU - Tadwalkar, Rigved
AU  - Tadwalkar R
AD  - UCLA Medical Center , Los Angeles, California , USA.
FAU - Chonde, Meshe
AU  - Chonde M
AD  - UPMC Presbyterian , Pittsburgh, Pennsylvania , USA.
FAU - Slipczuk, Leandro
AU  - Slipczuk L
AD  - Cedars-Sinai Heart Institute , Los Angeles, California , USA.
FAU - Cercek, Bojan
AU  - Cercek B
AD  - Cedars-Sinai Heart Institute , Los Angeles, California , USA.
FAU - Kar, Saibal
AU  - Kar S
AD  - Cedars-Sinai Heart Institute , Los Angeles, California , USA.
FAU - Siegel, Robert J
AU  - Siegel RJ
AD  - Cedars-Sinai Heart Institute , Los Angeles, California , USA.
LA  - eng
PT  - Journal Article
DEP - 20160801
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
PMC - PMC4975870
OTO - NOTNLM
OT  - HEART FAILURE
EDAT- 2016/08/23 06:00
MHDA- 2016/08/23 06:01
PMCR- 2016/08/01
CRDT- 2016/08/23 06:00
PHST- 2015/11/28 00:00 [received]
PHST- 2016/04/19 00:00 [revised]
PHST- 2016/06/07 00:00 [accepted]
PHST- 2016/08/23 06:00 [entrez]
PHST- 2016/08/23 06:00 [pubmed]
PHST- 2016/08/23 06:01 [medline]
PHST- 2016/08/01 00:00 [pmc-release]
AID - openhrt-2015-000378 [pii]
AID - 10.1136/openhrt-2015-000378 [doi]
PST - epublish
SO  - Open Heart. 2016 Aug 1;3(2):e000378. doi: 10.1136/openhrt-2015-000378. 
      eCollection 2016.