Page 127 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

Table 3. Univariate and multivariable cox regression analysis to identify associates of all-cause mortality.
Variable
Age
Male
BSA (m2)
eGFR <60 (mL/min/1.73m2) Hypertension
Diabetes mellitus Atrial fibrillation Ischaemic aetiology NYHA classification ≥ II Diuretics
MV intervention*
LV GLS (%)
E/e’
TAPSE/PASP ratio <0.35
p-value HR
<0.001 1.021 <0.001 1.470 0.558
<0.001 2.372 0.581
0.022 1.294 0.106
0.013 1.111 0.743
<0.001 1.799 0.253
<0.001 1.067 0.406
<0.001 1.283
95% CI
1.008-1.034 1.117-1.936
1.840-3.058 0.988-1.697 0.870-1.418 1.206-2.682 1.027-1.109
1.008-1.633
p-value
0.002 0.006
<0.001 0.062 0.398 0.004 0.001
0.043
Univariate analysis
HR 95% CI
1.030 1.019-1.043 1.582 1.224-2.046 1.172 0.689-1.995 2.845 2.242-3.611 0.936 0.741-1.183 1.362 1.045-1.774 1.209 0.961-1.522 1.340 1.064-1.688 1.098 0.629-1.915 2.204 1.493-3.253 1.148 0.906-1.455 1.090 1.051-1.131 1.002 0.997-1.007 1.637 1.300-2.061
Multivariable analysis
BSA = body surface area; CI = confidence interval; E = peak early diastolic transmitral flow velocity; e′ = peak early diastolic mitral annular tissue velocity; eGFR = estimated glomerular filtration rate; LV GLS = left ventricular global longitudinal strain; NYHA = New York Heart Association; PASP = pulmonary artery systolic pressure; TAPSE = tricuspid annular plane systolic excursion.
*Surgical mitral valve repair, surgical mitral valve replacement or transcatheter edge-to-edge mitral valve repair, compared to optimal medical therapy alone
Incremental prognostic value of TAPSE/PASP
A likelihood ratio test was performed to determine the incremental prognostic value of TAPSE alone and TAPSE/PASP over clinical and echocardiographic parameters, both as a continuous variable and as a dichotomous variable. No significant increase in the chi- square value was observed after the addition of TAPSE alone (as a continuous variable) to the baseline model (χ2 difference = 0.29, P= 0.790, Figure 3, Panel A). However, addition of TAPSE/PASP (as a continuous variable) to the baseline model did show a significant increase in the chi-square value (χ2 difference = 8.48, P= 0.002, Figure 3, Panel A). Similarly, introducing TAPSE alone as a dichotomous variable (<17 mm, according to contemporary guidelines)(13)
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