Author + information
- Peyman Naji,
- Fadi Asfahan,
- Tyler Barr,
- Richard Grimm,
- A. Gillinov,
- L. Leonardo Rodriguez,
- Tomislav Mihaljevic,
- Brian Griffin and
- Milind Desai
In organic mitral regurgitation (MR), exercise echocardiography (ExEc) aids in symptom evaluation & timing of surgery. We sought to assess predictors of long–term outcomes in patients with myxomatous MR undergoing ExEc.
We studied 884 consecutive patients (58±13 years, 67% men) with ≥ 3+ myxomatous MR (excluding prior valve surgery, functional & other causes) undergoing ExEc. Clinical data was recorded. Echocardiographic [degree of MR, left ventricular (LV) ejection fraction, indexed LV dimensions, right ventricular systolic pressure (RVSP)] & exercise variables [metabolic equivalents (METS), heart rate recovery (HRR) at 1st minute post–exercise] were recorded. Composite events of death, myocardial infarction & stroke were recorded.
Mean LV ejection fraction, indexed LV end–systolic dimension, rest RVSP, peak–stress RVSP, METs achieved, % age/gender–predicted METs & HRR were 58±5%, 1.6 ± 0.4 mm/m2, 31±12 mm Hg, 46±16 mm Hg, 9.6±3 & 33±14 beats, respectively. During 6.5±3 years of follow–up, there were 58 events. Cox survival analysis is shown in Figure. Patients achieving >100 % of predicted METs had 0.7 %/year event rate, vs. 1.4%/year in those achieving 85–100% & 2.1 %/year in those achieving < 85 % (log rank p–value < 0.001).
In patients with myxomatous MR undergoing ExEc, atrial fibrillation, lower achieved age/gender predicted METS & lower HRR were associated with worse outcomes. Patients with >100 % predicted METs had excellent long–term outcomes.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Valvular Heart Disease: Clinical II – Mitral Valve
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1112M–84
- 2013 American College of Cardiology Foundation