Page 123 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

was calculated as a measure of RV-PA coupling.
Follow-up
The primary endpoint was all-cause mortality. Survival data were obtained from the departmental cardiology information system (EPD-Vision 11.8.4.0; Leiden University Medical Center, Leiden, The Netherlands) which is linked to the governmental death registry database. Data at follow-up was complete for all patients.
Statistical analysis
Continuous data are presented as mean ± standard deviation when normally distributed or as median [Q1, Q3] when not normally distributed. Categorical data are presented as absolute numbers and percentages. Independent samples t-tests or Mann-Whitney U tests were used to compare continuous data, as appropriate. Categorical data were compared with the chi-square test. The changes in hazard ratio (HR) for all-cause mortality over a range of TAPSE/PASP (as a continuous variable) were investigated by a fitted spline curve. Kaplan-Meier analysis was performed to estimate cumulative survival rates for all-cause mortality and comparisons between groups were performed with the log-rank test. First the Kaplan-Meier analysis was performed with patients censored at the time of mitral valve interventions (i.e. Surgical mitral valve repair, surgical mitral valve replacement or transcatheter edge-to-edge mitral valve repair). Second the analyses was performed including the outcome after mitral valve interventions. Cox proportional hazards regression analysis was performed to identify the independent predictors of all-cause mortality. P-values <0.05 in univariable analysis were included in the multivariable model. HRs and 95% confidence intervals were calculated and reported. A likelihood ratio test was performed to investigate the incremental value of TAPSE/PASP over clinical and echocardiographic characteristics for the prediction of all-cause mortality. Changes in global chi-square values were calculated. All statistical analyses were performed using SPSS for Windows, version 23.0 (IBM, Armonk, NY, USA) and R version 3.4.4 (R Foundation for Statistical Computing, Vienna, Austria). A two-tailed p-value <0.05 was considered statistically significant for all analyses.
Results
Patient population
A total of 591 patients (mean age 66±11 years, 67% male) were included. Ischemic heart failure was present in 51% of the patient population. The majority of patients had NYHA II and III heart failure symptoms. The mean LVEF was 29±11% whereas the median
121
Ch 6