Department of Cardiology, CIBERCV, University of Alcala, Hospital Ramon y Cajal, Carretera de Colmenar Km 9, 100, 28034 Madrid, Spain.
Laboratory of Standard and Advanced Echocardiography, Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy.
Eur Heart J Cardiovasc Imaging. 2018 May 1;19(5):503-507. doi: 10.1093/ehjci/jey011.
To determine the prevalence of mitral regurgitation (MR) in a large cohort of consecutive patients undergoing clinically indicated echocardiography and to examine the distribution of primary and secondary MR.
All patients undergoing an echocardiographic study in 19 European centres within a 3-month period were prospectively included. MR assessment was performed as recommended by the European Association of Cardiovascular Imaging (EACVI). MR was classified according to mechanism as primary or secondary and aetiologies were reported. A total of 63 463 consecutive echocardiographic studies were reviewed. Any degree of MR was described in 15 501 patients. Concomitant valve disease of at least moderate grade was present in 28.5% of patients, being tricuspid regurgitation the most prevalent. In the subgroup of moderate and severe MR (n = 3309), 55% of patients had primary MR and 30% secondary MR. Both mechanisms were described in 14% of the studies. According to Carpentier's classification, 26.7% of MR were classified as I, 19.9% of MR as II, 22.4% of MR as IIIa, and 31.1% of MR as IIIb.
To date, this is the largest echocardiography-based study to analyse the prevalence and aetiology distribution of MR in Europe. The burden of secondary MR was higher than previously described, representing 30% of patients with significant MR. In our environment, degenerative disease is the most common aetiology of primary MR (60%), whereas ischaemic is the most common aetiology of secondary MR (51%). Up to 70% of patients with severe primary MR may have a Class I indication for surgery. However, the optimal therapeutic approach for secondary MR remains uncertain.
在接受临床指征明确的超声心动图检查的大量连续患者中确定二尖瓣反流（MR）的患病率，并检查原发性和继发性 MR 的分布。
在 3 个月内，19 个欧洲中心的所有接受超声心动图研究的患者均前瞻性纳入研究。MR 评估按照欧洲心血管影像协会（EACVI）的建议进行。MR 根据机制分为原发性或继发性，并报告病因。共回顾了 63463 例连续超声心动图研究。在 15501 例患者中描述了任何程度的 MR。在 28.5%的患者中存在至少中度等级的并发瓣膜疾病，其中三尖瓣反流最为常见。在中度和重度 MR（n=3309）亚组中，55%的患者有原发性 MR，30%有继发性 MR。两种机制在 14%的研究中均有描述。根据 Carpentier 分类，26.7%的 MR 为 I 级，19.9%的 MR 为 II 级，22.4%的 MR 为 IIIa 级，31.1%的 MR 为 IIIb 级。
这是迄今为止基于超声心动图分析欧洲 MR 患病率和病因分布的最大研究。继发性 MR 的负担高于以前的描述，占有显著 MR 的患者的 30%。在我们的环境中，退行性疾病是原发性 MR（60%）最常见的病因，而缺血是继发性 MR（51%）最常见的病因。多达 70%的严重原发性 MR 患者可能有手术 I 类适应证。然而，继发性 MR 的最佳治疗方法仍不确定。
