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Changes of echocardiographic parameters in primary mitral regurgitation and determinants of symptom: an assessment from the Asian Valve Registry data.
- Source :
-
Heart and vessels [Heart Vessels] 2020 Apr; Vol. 35 (4), pp. 555-563. Date of Electronic Publication: 2019 Oct 03. - Publication Year :
- 2020
-
Abstract
- Clinicians often have a difficulty in determining the presence of mitral regurgitation (MR)-related symptoms because of subjectivity. However, there are few actual measurement data for echocardiographic left ventricular (LV) and left atrial (LA) size related to the severity of MR and the relationship between MR-related symptoms and these echocardiographic parameters. Among patients enrolled in the Asian Valve Registry, we investigated 778 consecutive patients with primary MR showing sinus rhythm. Symptoms were determined by New York Heart Association grade (≤ II or ≥ III). MR severity was mild in 106, moderate in 285, and severe in 387 patients. LA volume index, LV end-diastolic diameter, and LV mass index increased with increasing MR grade [LA volume index: 47.9 (mild), 56.2 (moderate), and 64.9 ml/m <superscript>2</superscript> (severe) (p < 0.001), LV end-diastolic diameter: 51.2, 54.5, 58.1 mm (p < 0.001), and LV mass index: 101, 109, 123 g/m <superscript>2</superscript> (p < 0.001)]. Regarding moderate and severe MR, 70 patients (10.4%) were symptomatic. In multivariable analysis, for being symptomatic in moderate and severe MR patients, LV mass index (odds ratio [OR] per 10 g/m <superscript>2</superscript> increment; 1.09; 95% confidence interval [CI]: 1.005-1.18, p = 0.040), ejection fraction (OR per 1% increment; 0.96, 95%CI: 0.93-0.98, p < 0.001), female gender (OR 2.28; 95% CI: 1.31-3.98, p = 0.004), and heart rate (OR per 1 bpm increment; 1.03; 95%CI: 1.01-1.05, p = 0.007) were independent factors. LV and LA parameters on echocardiography worsened as MR severity progressed. Larger LV mass index and lower ejection fraction were independent determinant factors for MR-related symptoms. We should also pay attention to LV hypertrophy in patients with primary MR.
- Subjects :
- Adult
Aged
Asia
Diastole
Echocardiography, Doppler
Female
Heart Atria diagnostic imaging
Heart Ventricles diagnostic imaging
Humans
Logistic Models
Male
Middle Aged
Mitral Valve Insufficiency complications
Mitral Valve Insufficiency diagnostic imaging
Multivariate Analysis
Prospective Studies
Registries
Severity of Illness Index
Stroke Volume
Atrial Function, Left
Heart Atria physiopathology
Mitral Valve Insufficiency physiopathology
Ventricular Dysfunction, Left physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1615-2573
- Volume :
- 35
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Heart and vessels
- Publication Type :
- Academic Journal
- Accession number :
- 31583450
- Full Text :
- https://doi.org/10.1007/s00380-019-01514-x