Prognostic Value of Mitral Regurgitation in Patients with Primary Hypertrophic Cardiomyopathy
Аутори
Tešić, MiloradTravica, Lazar
Giga, Vojislav
Jovanović, Ivana
Trifunović-Zamaklar, Danijela
Popović, Dejana
Mladenović, Đorđe
Radomirović, Marija
Vratonjić, Jelena
Bošković, Nikola
Dedić, Srđan
Nedeljković Arsenović, Olga
Aleksandrić, Srđan
Juričić, Stefan
Beleslin, Branko
Đorđević Dikić, Ana
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Background and Objectives: Mitral valve pathology and mitral regurgitation (MR) are very common in patients with hypertrophic cardiomyopathy (HCM), and the evaluation of mitral valve anatomy and degree of MR is important in patients with HCM. The aim of our study was to examine the potential influence of moderate or moderately severe MR on the prognosis, clinical presentation, and structural characteristics of HCM patients. Materials and Methods: A prospective study examined 176 patients diagnosed with primary asymmetric HCM. According to the severity of the MR, the patients were divided into two groups: Group 1 (n = 116) with no/trace or mild MR and Group 2 (n = 60) with moderate or moderately severe MR. All patients had clinical and echocardiographic examinations, as well as a 24 h Holter ECG. Results: Group 2 had significantly more often the presence of the obstructive type of HCM (p < 0.001), syncope (p = 0.030), NYHA II class (p < 0.001), and atrial fibrillation (p = 0.023). Also,... Group 2 had an enlarged left atrial dimension (p < 0.001), left atrial volume index (p < 0.001), and indirectly measured systolic pressure in the right ventricle (p < 0.001). Patients with a higher grade of MR had a significantly higher E/e' (p < 0.001) and, as a result, higher values of Nt pro BNP values (p < 0.001) compared to Group 1. Kaplan-Meier analysis demonstrated that the event-free survival rate during a median follow-up of 88 (IQR 40-112) months was significantly higher in Group 1 compared to Group 2 (84% vs. 45% at 8 years; log-rank 20.4, p < 0.001). After adjustment for relevant confounders, the presence of moderate or moderately severe MR remained as an independent predictor of adverse outcomes (HR 2.788; 95% CI 1.221-6.364, p = 0.015). Conclusions: The presence of moderate or moderately severe MR was associated with unfavorable long-term outcomes in HCM patients.
Кључне речи:
echocardiography / hypertrophic cardiomyopathy / mitral regurgitation / prognosisИзвор:
Medicina (Kaunas, Lithuania), 2023, 59, 10Издавач:
- MDPI
Финансирање / пројекти:
- Акутни коронарни синдром: истраживање вулнерабилности (плака, крви и миокарда), оптимално лечење и одређивање прогностичких фактора (RS-MESTD-Integrated and Interdisciplinary Research (IIR or III)-41022)
- Асимптоматска митрална регургитација, нови погледи на стари проблем (RS-MESTD-Basic Research (BR or ON)-175086)
DOI: 10.3390/medicina59101798
ISSN: 1648-9144
PubMed: 37893516
Scopus: 2-s2.0-85175279923
Институција/група
PharmacyTY - JOUR AU - Tešić, Milorad AU - Travica, Lazar AU - Giga, Vojislav AU - Jovanović, Ivana AU - Trifunović-Zamaklar, Danijela AU - Popović, Dejana AU - Mladenović, Đorđe AU - Radomirović, Marija AU - Vratonjić, Jelena AU - Bošković, Nikola AU - Dedić, Srđan AU - Nedeljković Arsenović, Olga AU - Aleksandrić, Srđan AU - Juričić, Stefan AU - Beleslin, Branko AU - Đorđević Dikić, Ana PY - 2023 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/5203 AB - Background and Objectives: Mitral valve pathology and mitral regurgitation (MR) are very common in patients with hypertrophic cardiomyopathy (HCM), and the evaluation of mitral valve anatomy and degree of MR is important in patients with HCM. The aim of our study was to examine the potential influence of moderate or moderately severe MR on the prognosis, clinical presentation, and structural characteristics of HCM patients. Materials and Methods: A prospective study examined 176 patients diagnosed with primary asymmetric HCM. According to the severity of the MR, the patients were divided into two groups: Group 1 (n = 116) with no/trace or mild MR and Group 2 (n = 60) with moderate or moderately severe MR. All patients had clinical and echocardiographic examinations, as well as a 24 h Holter ECG. Results: Group 2 had significantly more often the presence of the obstructive type of HCM (p < 0.001), syncope (p = 0.030), NYHA II class (p < 0.001), and atrial fibrillation (p = 0.023). Also, Group 2 had an enlarged left atrial dimension (p < 0.001), left atrial volume index (p < 0.001), and indirectly measured systolic pressure in the right ventricle (p < 0.001). Patients with a higher grade of MR had a significantly higher E/e' (p < 0.001) and, as a result, higher values of Nt pro BNP values (p < 0.001) compared to Group 1. Kaplan-Meier analysis demonstrated that the event-free survival rate during a median follow-up of 88 (IQR 40-112) months was significantly higher in Group 1 compared to Group 2 (84% vs. 45% at 8 years; log-rank 20.4, p < 0.001). After adjustment for relevant confounders, the presence of moderate or moderately severe MR remained as an independent predictor of adverse outcomes (HR 2.788; 95% CI 1.221-6.364, p = 0.015). Conclusions: The presence of moderate or moderately severe MR was associated with unfavorable long-term outcomes in HCM patients. PB - MDPI T2 - Medicina (Kaunas, Lithuania) T1 - Prognostic Value of Mitral Regurgitation in Patients with Primary Hypertrophic Cardiomyopathy VL - 59 IS - 10 DO - 10.3390/medicina59101798 ER -
@article{ author = "Tešić, Milorad and Travica, Lazar and Giga, Vojislav and Jovanović, Ivana and Trifunović-Zamaklar, Danijela and Popović, Dejana and Mladenović, Đorđe and Radomirović, Marija and Vratonjić, Jelena and Bošković, Nikola and Dedić, Srđan and Nedeljković Arsenović, Olga and Aleksandrić, Srđan and Juričić, Stefan and Beleslin, Branko and Đorđević Dikić, Ana", year = "2023", abstract = "Background and Objectives: Mitral valve pathology and mitral regurgitation (MR) are very common in patients with hypertrophic cardiomyopathy (HCM), and the evaluation of mitral valve anatomy and degree of MR is important in patients with HCM. The aim of our study was to examine the potential influence of moderate or moderately severe MR on the prognosis, clinical presentation, and structural characteristics of HCM patients. Materials and Methods: A prospective study examined 176 patients diagnosed with primary asymmetric HCM. According to the severity of the MR, the patients were divided into two groups: Group 1 (n = 116) with no/trace or mild MR and Group 2 (n = 60) with moderate or moderately severe MR. All patients had clinical and echocardiographic examinations, as well as a 24 h Holter ECG. Results: Group 2 had significantly more often the presence of the obstructive type of HCM (p < 0.001), syncope (p = 0.030), NYHA II class (p < 0.001), and atrial fibrillation (p = 0.023). Also, Group 2 had an enlarged left atrial dimension (p < 0.001), left atrial volume index (p < 0.001), and indirectly measured systolic pressure in the right ventricle (p < 0.001). Patients with a higher grade of MR had a significantly higher E/e' (p < 0.001) and, as a result, higher values of Nt pro BNP values (p < 0.001) compared to Group 1. Kaplan-Meier analysis demonstrated that the event-free survival rate during a median follow-up of 88 (IQR 40-112) months was significantly higher in Group 1 compared to Group 2 (84% vs. 45% at 8 years; log-rank 20.4, p < 0.001). After adjustment for relevant confounders, the presence of moderate or moderately severe MR remained as an independent predictor of adverse outcomes (HR 2.788; 95% CI 1.221-6.364, p = 0.015). Conclusions: The presence of moderate or moderately severe MR was associated with unfavorable long-term outcomes in HCM patients.", publisher = "MDPI", journal = "Medicina (Kaunas, Lithuania)", title = "Prognostic Value of Mitral Regurgitation in Patients with Primary Hypertrophic Cardiomyopathy", volume = "59", number = "10", doi = "10.3390/medicina59101798" }
Tešić, M., Travica, L., Giga, V., Jovanović, I., Trifunović-Zamaklar, D., Popović, D., Mladenović, Đ., Radomirović, M., Vratonjić, J., Bošković, N., Dedić, S., Nedeljković Arsenović, O., Aleksandrić, S., Juričić, S., Beleslin, B.,& Đorđević Dikić, A.. (2023). Prognostic Value of Mitral Regurgitation in Patients with Primary Hypertrophic Cardiomyopathy. in Medicina (Kaunas, Lithuania) MDPI., 59(10). https://doi.org/10.3390/medicina59101798
Tešić M, Travica L, Giga V, Jovanović I, Trifunović-Zamaklar D, Popović D, Mladenović Đ, Radomirović M, Vratonjić J, Bošković N, Dedić S, Nedeljković Arsenović O, Aleksandrić S, Juričić S, Beleslin B, Đorđević Dikić A. Prognostic Value of Mitral Regurgitation in Patients with Primary Hypertrophic Cardiomyopathy. in Medicina (Kaunas, Lithuania). 2023;59(10). doi:10.3390/medicina59101798 .
Tešić, Milorad, Travica, Lazar, Giga, Vojislav, Jovanović, Ivana, Trifunović-Zamaklar, Danijela, Popović, Dejana, Mladenović, Đorđe, Radomirović, Marija, Vratonjić, Jelena, Bošković, Nikola, Dedić, Srđan, Nedeljković Arsenović, Olga, Aleksandrić, Srđan, Juričić, Stefan, Beleslin, Branko, Đorđević Dikić, Ana, "Prognostic Value of Mitral Regurgitation in Patients with Primary Hypertrophic Cardiomyopathy" in Medicina (Kaunas, Lithuania), 59, no. 10 (2023), https://doi.org/10.3390/medicina59101798 . .