Page 72 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

Chapter four. Regurgitant Volume/Left Ventricular End-Diastolic Volume Ratio
independent predictors of all-cause mortality, a Cox proportional hazards regression analysis was performed. The proportional hazards assumption was confirmed using statistics and graphs on the basis of the Schoenfeld residuals. HR and 95% confidence interval (CI) were calculated and reported. The p < 0.05 in univariable analysis was considered statistically significant and included in the multivariable model.
Results
Patient population
A total of 379 patients (mean age 67 ± 11 years; 63% male) were included. Baseline clinical and echocardiographic characteristics are summarized in Tables 1 and 2. Nonischemic HF was present in 51% of the total population, and the majority of the patients were in NYHA functional class II to III. Mean LVEF was 30% ± 11%. Median LVEDV was 189 ml (IQR: 138 to 245 ml). Mean EROA and mean RVol were 24 ± 11 mm2 and 34 ± 15 ml/beat, respectively. During median follow-up of 5 months (IQR: 1 to 114 months), 234 patients received MV intervention.
Table 1. Clinical Characteristics at Baseline According to RVol/EDV Ratio
Age (yrs)
Male
BSA (m2)
Atrial fibrillation
Hypertension
Diabetes mellitus
eGFR (ml/ min/1.73 m2)
Total Population (N = 379)
67 ± 11 240 (63) 1.92 ± 0.2 164 (43) 163 (43) 95 (25)
61 ± 25
RVol/EDV Ratio <20% (n = 244)
66 ± 11 173 (71) 1.94 ± 0.21 86 (52)
95 (39)
64 (26)
60 ± 25
124 (51) 230 (49)
20 (8) 44 (18) 147 (60) 33 (14)
163 (67) 217 (89)
RVol/EDV
Ratio ≥20% (n = 135)
68 ± 11
67 (50) 1.89 ± 0.22 78 (58)
68 (50)
31 (23)
63 ± 26
63 (47) 72 (53)
8 (6) 41 (30) 67 (50) 19 (14)
102 (76) 104 (77)
p Value
0.070 <0.001 0.023 <0.001 0.031 0.482
0.345
0.439 0.439
0.041
0.075 0.002
Heart failure etiology
Ischemic Nonischemic
NYHA functional class
I II III IV
Medication Beta-blockers Diuretics
187 (49) 192 (51)
28 (7) 85 (22) 214 (57) 52 (14)
265 (70) 321 (85)
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