Page 106 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

Chapter five. MV geometry: The COAPT Trial
also significantly associated with the primary endpoint. By multivariable analysis, the baseline anteroposterior mitral annulus diameter was the only echocardiographic variable independently associated with the primary endpoint. Of note, baseline mitral EROA was not an independent predictor of the 2-year composite clinical outcome. A history of atrial fibrillation or flutter, New York Heart Association (NYHA) class and baseline BNP plasma levels were also independently associated with occurrence of the primary composite endpoint within 2 years.
Table 4. Univariable and multivariable predictors of the composite outcome of all-cause mortality or heart failure hospitalization at 2-year follow-up.
Univariable analysis
Variable HR (95% CI) p-Value
Echocardiographic parameters at baseline
Multivariable analysis
HR (95% CI) p-Value
1.49 (1.02 - 0.04 2.19)
Anterior-posterior mitral annulus dia- meter (per cm)
Intercommisural mitral annulus dia- meter (per cm)
Anterior mitral valve leaf- let length (per cm)
Posterior mitral valve leaf- let length (per cm)
Coaptation to septum distance (per cm)
Tenting height (per cm) Tenting area (per cm2)
Anterior papillary muscle to MV annulus distance (per cm)
Posterior papillary muscle to MV annulus distance (per cm)
Basal mitral anterior leaflet angle (per degree)
Distal mitral anterior leaflet angle (per degree)
Posterior mitral leaflet angle (per degree)
Tethering location
Inferior basal/inferolateral LV aneurysm
Posterior PM to annulus distance, 4CH (per cm)
Left ventricular ejection fraction (per 10% increment)
Mitral regurgitation grade 4+ (vs. 3+)
Left ventricular end-diastolic dimension (per cm)
1.55 (1.16 - 2.08) 0.003 1.38 (1.07 - 1.80) 0.01 1.30 (0.95 - 1.78) 0.10 1.09 (0.65 - 1.83) 0.75 1.00 (0.77 - 1.28) 0.97
1.25 (0.79 - 1.98) 0.35 1.17 (1.00 - 1.38) 0.054 1.17 (0.87 - 1.58) 0.30
1.22 (0.91 - 1.64) 0.18
1.01 (0.99 - 1.03) 0.42
1.01 (0.99 - 1.03) 0.34
1.00 (0.99 - 1.01) 0.76
1.01 (0.91 - 1.12) 0.87 1.10 (0.83 - 1.45) 0.50
0.98 (0.75 - 1.27) 0.86
0.90 (0.80 - 1.02) 0.09
1.32 (1.07 - 1.64) 0.01
1.10 (0.95 - 1.27) 0.22
1.06 (0.85 - 1.33) 0.59
0.91 (0.79 - 1.05) 0.21 0.93 (0.69 - 1.27) 0.13
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