Department of Cardiology, The Second Affiliated Hospital of Shenzhen University (The People's Hospital of Baoan Shenzhen), Shenzhen, 518100, China.
Graduate School, Guangdong Medical University, Zhanjiang, 524000, China.
BMC Cardiovasc Disord. 2024 Jul 13;24(1):357. doi: 10.1186/s12872-024-04017-4.
The epidemiological distribution of functional mitral regurgitation (FMR) in heart failure (HF) and mildly reduced ejection fraction (HFmrEF) patients and its impact on outcomes remains unclear. We attempt to investigate the prognosis of FMR in patients with HFmrEF.
The HF center registry study is a prospective, single, observational study conducted at the Second Affiliated Hospital of Shenzhen University, where 2330 patients with acute HF (AHF) were enrolled and 890 HFmrEF patients were included in the analysis. The patients were stratified into three categories based on the severity of FMR: none/mild, moderate, and moderate-to-severe/severe groups. Subsequently, a comparison of the clinical characteristics among these groups was conducted, along with an assessment of the incidence of the primary endpoint (comprising all-cause mortality and readmission for HF) during a one-year follow-up period.
The one-year follow-up results indicated that the primary composite endpoint occurrence rates in the three groups were 23.5%, 32.9%, and 36.5%, respectively. The all-cause mortality rates in the three groups were 9.3%, 13.7%, and 16.4% respectively. Survival analysis demonstrated a statistically significant difference in the occurrence rates of the primary composite endpoint and all-cause mortality among the three groups (P < 0.05). Multifactor Cox regression revealed that moderate FMR and moderate-to-severe/severe FMR were independent risk factors for adverse clinical prognosis in HFmrEF patients, with hazard ratios and 95% confidence intervals of 1.382 (1.020-1.872, P = 0.037) and 1.546 (1.092-2.190, P = 0.014) respectively.
Moderate FMR and moderate-to-severe/severe FMR independently predict an unfavorable prognosis in patients with HFmrEF.
射血分数轻度降低的心衰（HFmrEF）患者中功能性二尖瓣反流（FMR）的流行病学分布及其对结局的影响尚不清楚。我们试图研究 FMR 在 HFmrEF 患者中的预后。
HF 中心登记研究是一项前瞻性、单中心、观察性研究，在深圳大学第二附属医院进行，共纳入 2330 例急性心衰（AHF）患者，其中 890 例 HFmrEF 患者纳入分析。根据 FMR 的严重程度将患者分为三组：无/轻度、中度和中重度/重度。随后，比较三组之间的临床特征，并评估一年随访期间主要终点（包括全因死亡率和因心衰再住院）的发生率。
一年随访结果显示，三组的主要复合终点发生率分别为 23.5%、32.9%和 36.5%，三组的全因死亡率分别为 9.3%、13.7%和 16.4%。生存分析显示三组主要复合终点和全因死亡率的发生率存在统计学差异（P<0.05）。多因素 Cox 回归显示，中度 FMR 和中重度/重度 FMR 是 HFmrEF 患者不良临床预后的独立危险因素，风险比和 95%置信区间分别为 1.382（1.020-1.872，P=0.037）和 1.546（1.092-2.190，P=0.014）。
中度 FMR 和中重度/重度 FMR 独立预测 HFmrEF 患者预后不良。
