PMID- 29399763
OWN - NLM
STAT- MEDLINE
DCOM- 20181126
LR  - 20181126
IS  - 1897-4279 (Electronic)
IS  - 0022-9032 (Linking)
VI  - 76
IP  - 6
DP  - 2018
TI  - Significant mitral regurgitation as a predictor of long-term prognosis in 
      patients receiving cardiac resynchronisation therapy.
PG  - 987-992
LID - 10.5603/KP.a2018.0035 [doi]
AB  - BACKGROUND: Cardiac resynchronisation therapy (CRT) has been shown to reduce 
      functional mitral regurgitation, although the relationship between significant 
      mitral regurgitation (SMR) and the clinical prognosis of CRT remains uncertain. 
      AIM: We sought to investigate the association of baseline SMR with long-term 
      outcomes in patients undergoing CRT. METHODS: A total of 296 consecutive patients 
      undergoing CRT were enrolled. SMR was quantified by colour Doppler in all 
      patients at baseline and defined as level >/= 3 on the severity scale. The primary 
      endpoints included all-cause death, heart failure hospitalisation (HFH), and 
      heart transplantation, and the secondary endpoints were response to CRT and New 
      York Heart Association (NYHA) class III or IV six months after CRT implantation. 
      RESULTS: The mean age was 59 +/- 11 years, and 202 (68.2%) patients were male. 
      Among all patients, 124 (41.9%) presented with baseline SMR. Over a mean 
      follow-up of 4.17 +/- 3.16 years, there were 53 (17.9%) cases of all-cause death, 
      41 (13.8%) cases of HFH, and four (1.4%) cases of heart transplantation. SMR was 
      positively associated with primary endpoint events (hazard ratio [HR] 1.602, 95% 
      confidence interval [CI] 1.083-2.371, p = 0.019), HFH (HR 3.567, 95% CI 
      1.763-7.219, p < 0.001) and NYHA class III or IV (HR 2.101, 95% CI 1.313-3.363, p 
      = 0.002). After adjusting for multiple factors, we found that SMR (HR 1.785, 95% 
      CI 1.091-2.920, p = 0.021), ischaemic heart disease (HR 1.628, 95% CI 
      1.062-2.494, p = 0.025), and the lack of use of spironolactone (HR 2.044, 95% CI 
      1.040-4.017, p = 0.038) were independent predictors of primary endpoints, and SMR 
      remained an independent predictor of HFH (HR 4.622, 95% CI 1.955-10.923, p < 
      0.001). CONCLUSIONS: Significant mitral regurgitation before CRT implantation was 
      strongly associated with long-term poor progno-sis. SMR was positively associated 
      with HFH rather than all-cause death and CRT response.
FAU - Jin, Han
AU  - Jin H
FAU - Yang, Shengwen
AU  - Yang S
FAU - Hua, Wei
AU  - Hua W
AD  - The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, 
      Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of 
      Medical Sciences and Peking Union Medical College, The Cardiac Arrhythmia Center, 
      Fuwai Hospital, Beilishi Road No. 167, Xicheng District, 100037 Beijing, China. 
      drhuaweifw@sina.com.
FAU - Gu, Min
AU  - Gu M
FAU - Niu, Hongxia
AU  - Niu H
FAU - Ding, Ligang
AU  - Ding L
FAU - Wang, Jing
AU  - Wang J
FAU - Xue, Cong
AU  - Xue C
FAU - Zhang, Shu
AU  - Zhang S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180205
PL  - Poland
TA  - Kardiol Pol
JT  - Kardiologia polska
JID - 0376352
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*diagnostic imaging
MH  - Prognosis
OTO - NOTNLM
OT  - cardiac resynchronisation therapy
OT  - heart failure
OT  - significant mitral regurgitation
EDAT- 2018/02/06 06:00
MHDA- 2018/11/27 06:00
CRDT- 2018/02/06 06:00
PHST- 2017/10/24 00:00 [received]
PHST- 2018/01/22 00:00 [accepted]
PHST- 2018/01/19 00:00 [revised]
PHST- 2018/02/06 06:00 [pubmed]
PHST- 2018/11/27 06:00 [medline]
PHST- 2018/02/06 06:00 [entrez]
AID - VM/OJS/KP/11785 [pii]
AID - 10.5603/KP.a2018.0035 [doi]
PST - ppublish
SO  - Kardiol Pol. 2018;76(6):987-992. doi: 10.5603/KP.a2018.0035. Epub 2018 Feb 5.