Page 35 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

performed at 36 months of follow-up to evaluate early vs. late outcomes between men and women. Independent associates for all-cause mortality were evaluated using Cox proportional hazards regression analysis. The hazard ratio (HR) and 95% confidence intervals (CI) were calculated and reported. Variables with a p-value <0.05 were considered statistically significant and were included in the multivariable model. All statistical analyses were performed using SPSS for Windows, version 23.0 (IBM, Armonk, NY, USA), with a two-tailed p-value <0.05 being considered statistically significant.
Results
Patient population
A total of 698 patients (mean age 66±11 years) with significant secondary MR were included. Ischemic heart failure was present in 53% of the total population. The majority of the patients presented with heart failure symptoms NYHA functional class III (60%). The mean LVEF was 29±11% and the mean LV GLS was 7.8±3.8%. The majority of the patients (82%) had moderate-to-severe or severe MR. Tables 1 and 2 summarize the baseline clinical and echocardiographic characteristics for the total population and the differences between sexes.
There were 471 (67%) men (mean age 67±10 years) and 227 (33%) women (mean age 65±13). No differences were observed in the prevalence of atrial fibrillation or other cardiovascular risk factors (i.e. hypertension and/or diabetes mellitus). In terms of heart failure etiology, men more frequently had ischemic heart failure (61%) whereas women more frequently had non-ischemic heart failure (63%). Although women had more severe heart failure symptoms as compared to men, the difference did not reach statistical significance. In terms of echocardiographic characteristics, women had significantly smaller LV volumes when compared to men, but no significant difference was observed in LVEF. However, LV systolic function was slightly better in women than in men when assessed with LV GLS (LV GLS 7.5±3.6% in men vs. 8.5±4.1% in women; P= 0.004). No differences were observed in MR grade between men and women.
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