Author + information
- Pieter van der Bijl,
- Mand Khidir,
- Nina Marsan,
- Victoria Delgado and
- Jeroen Bax
Background: The long-term outcome of changes in functional mitral regurgitation (FMR) in heart failure (HF) recipients of cardiac resynchronization therapy (CRT) is unclear.
Methods: A total of 1313 patients (66±11 years, 77% male, 59% ischemic heart disease) treated with CRT were evaluated. Patients were divided into 4 groups of FMR according to the evolution at 6 months after CRT: none/mild FMR which remained unchanged at 6 months (grade 0-1 FMR unchanged, n=609), none/mild FMR which worsened to moderate/severe (grade 0-1 FMR worsened, n=66), moderate/severe FMR which improved to none/mild (grade 2-4 improved, n=209) and moderate/severe FMR which remained unchanged (grade 2-4 unchanged, n=309). Complete echocardiographic measurements were performed at baseline and at 6 months follow-up in 1253 patients.
Results: Over a mean follow-up of 51±38 months, 30% of patients died. Those with FMR 0-1 at 6 month follow-up had lower event rates for all-cause mortality, compared to patients with FMR 2-4 (Log-rank test P<0.001; Figure). Baseline FMR 2-4 that remained unchanged at 6 months follow-up was independently associated with increased all-cause mortality (hazard ratio, 1.770; 95% confidence interval, 1.411-2.221, P<0.001) after correcting for left ventricular reverse remodeling.
Conclusions: Moderate to severe FMR at baseline that remained unchanged at 6 months after CRT, was independently associated with increased mortality.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 10:15 a.m.-10:25 a.m.
Session Title: Leading Us Astray? Pacemakers in Cardiomyopathies
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1308M-07
- 2017 American College of Cardiology Foundation