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Determinants of clinical outcomes in patients with mixed mitral valve disease

Authors
 In-Jeong Cho  ;  Sang-Eun Lee  ;  Hyeonju Jeong  ;  Hyuk-Jae Chang 
Citation
 ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, Vol.37(8) : 1164-1170, 2020-08 
Journal Title
 ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES 
ISSN
 0742-2822 
Issue Date
2020-08
Keywords
mitral valve ; regurgitation ; stenosis
Abstract
Background: Although significant stenosis and regurgitation can be observed on a single heart valve, studies on the outcome predictors for mixed valve disease are limited. The purpose of the current study was to investigate the fate and determinants of clinical outcomes in patients with mixed single mitral valve disease who have concomitant mitral stenosis (MS) and mitral regurgitation (MR). Methods: We retrospectively reviewed 82 consecutive patients with rheumatic heart disease who had both significant MS (MVA ≤ 1.5 cm2 ) and at least moderate MR, excluding patients with significant aortic valve stenosis or regurgitation. The primary endpoint was a composite of all-cause mortality during follow-up, mitral valve replacement, heart failure admission, and stroke. Results: There were 37 events (45.1%), 5 all-cause deaths (6.0%), and 32 mitral valve replacements (39.0%). In a multivariable Cox regression analysis, a transmitral mean pressure gradient (TMPG) over 6 mm Hg was the only independent echocardiographic predictor for events (hazard ratio 3.69, 95% confidential interval 1.31-10.44, P = .014), after adjusting for sex, age, symptoms, and the severity of MS and MR. The estimated 6-year event-free survival rate was significantly lower in patients with TMPG ≥ 6 mm Hg than in those with TMPG < 6 mm Hg (76.3% vs 22.9%, log-rank P < .001). Conclusion: Transmitral mean pressure gradient, which reflects the hemodynamic burden of the mitral valve lesion, appears to be the most important echocardiographic predictor of clinical outcomes in patients with mixed mitral valve disease.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/echo.14673
DOI
10.1111/echo.14673
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181416
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