Ischemic or Nonischemic Functional Mitral Regurgitation and Outcomes in Patients With Acute Decompensated Heart Failure With Preserved or Reduced Ejection Fraction

Katsuya Kajimoto, Yuichiro Minami, Shigeru Otsubo, Naoki Sato, Naoki Sato, Kuniya Asai, Ryo Munakata, Toshiyuki Aokage, Asuka Yoshida, Yuichiro Minami, Dai Yumino, Masayuki Mizuno, Erisa Kawada, Kentaro Yoshida, Yuri Ozaki, Tomohito Kogure, Shintaro Haruki, Masayuki Mizuno, Katsuya Kajimoto, Koichi NakaoTadashi Sawamura, Toshiaki Nuki, Ryoji Ishiki, Shigeki Yokota, Hiroyuki Fujinaga, Takashi Yamamoto, Kenji Harada, Akihiro Saito, Norihito Kageyama, Takanobu Okumura, Noritake Hata, Koji Murai, Ayaka Nozaki, Hidekazu Kawanaka, Jun Tanabe, Yukihito Sato, Katsuhisa Ishii, Hitoshi Oiwa, Tomoaki Matsumoto, Daisuke Yoshida, Nobuo Kato, Hiroshi Suzuki, Nobuyuki Shimizu, Takehiko Keida, Masaki Fujita, Kentaro Nakamura, Toshiya Chinen, Kentaro Meguro, Tatsuro Kikuchi, Toshiyuki Nishikido, Marohito Nakata, Tatsuya Yamashita, Masaya Nakata, Akitoshi Hirono, Kazuaki Mitsudo, Kazushige Kadota, Noriko Makita, Nagisa Watanabe, Masaaki Kawabata, Kenichi Fujii, Shinichi Okuda, Shigeki Kobayashi, Ikuo Moriuchi, Kiyo o. Mizuno, Kazuo Osato, Tatsuaki Murakami, Yoshifumi Shimada, Katsushi Misawa, Hiromasa Kokado, Takashi Fujita, Yoshitomo Fukuoka, Syu Takabatake, Yoshifumi Takata, Manabu Miyagi, Nobuhiro Tanaka, Akira Yamashina, Shinji Sudo, Koichi Shimamura, Michitaka Nagashima, Tomoya Kaneda, Kosei Ueda, Hiromasa Kato, Toshinori Higashikata, Kanichi Fujimori, Hiroshi Kobayashi, Shinya Fujii, Masahiro Yagi, Yuri Ozaki, Jyunko Takaki, Eiji Yamashita, Takuji Toyama, Tetsuo Hirata, Kazuho Kamisihima, Toshiaki Oka, Ryushi Komatsu, Akira Itoh, Takahiko Naruko, Yukio Abe, Eiichirou Nakagawa, Atsuko Furukawa, Naoto Kinou, Shoko Uematsu, Isao Tabuchi, Taku Imai, Takafumi Sakamoto, Koji Todaka, Yuji Koide, Koji Maemura, Koichiro Yoshioka, Akiomi Yoshihisa, Takamasa Sato, Yasuchika Takeishi, Toshiaki Ebina, Kazuo Kimura, Masaaki Konishi, Masahiko Kato, Yoshiharu Kinugasa, Katsunori Ishida, Shinobu Sugihara, Kiyotaka Yanagihara, Toshiharu Takeuchi, Motoi Okada, Naoyuki Hasebe, Tetsuo Sakai, Taku Asano, Yoshino Minoura, Tsutomu Toshida, Takatoshi Sato, Yuya Yokota, Seita Kondo, Yasushi Sakata, Issei Komuro, Kinya Otsu, Shizuya Yamashita, Yoshihiro Asano, Asuka Yoshida, Katsuya Kajimoto, Kazunori Kashiwase, Yasunori Ueda, Taizo Kondo, Katsuhiro Kawaguchi, Akinori Sawamura, Taro Saito, Toru Higa, Hiroo Noguchi, Yoko Yanagita, Keita Nakamura, Tomo Komaki, Toshihiro Muramatsu, Tomomi Koizumi, Yoshie Nakajima, Toshihiko Kikutani, Yoshifimi Ikeda, Toru Tamaki, Shuhei Funada, Harumi Ogawa, Koichiro Sakuragawa, Shun Kohsaka, Shin ichi Ando, Toshiaki Kadokami, Eiko Ishida, Katsumi Ide, Yohei Sotomi, Yoshiharu Higuchi, Motoko Uehara, Toshihiko Goto, Nobuyuki Ohte, Masanobu Miura, Nobuyuki Shiba, Kotaro Nochioka, Hiroaki Shimokawa, Shiro Ishihara, Tokushi Koga, Shinichiro Fujishima, Shigeru Kaseda, Yoshie Haga, Keisuke Kida, Kazuho Kamisihima, Makiko Nakamura, Osahiko Sunagawa, Takafumi Miyara, Youji Taba, Takashi Touma, Osamu Shinjo, Yoshioki Nishimura, Kazuomi Kario, Hayato Shimizu, Takahiro Uchida, Ken ichi Amitani, Naoki Sato, Katsunori Shimada

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Abstract

The aim of this study was to evaluate the association of functional mitral regurgitation (FMR), preserved or reduced ejection fraction (EF), and ischemic or nonischemic origin with outcomes in patients discharged alive after hospitalization for acute decompensated heart failure (HF). Of the 4,842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 3,357 patients were evaluated to assess the association of FMR, preserved or reduced EF, and ischemic or nonischemic origin with the primary end point (all-cause death and readmission for HF after discharge). At the time of discharge, FMR was assessed semiquantitatively (classified as none, mild, or moderate to severe) by color Doppler analysis of the regurgitant jet area. According to multivariable analysis, in the ischemic group, either mild or moderate to severe FMR in patients with a preserved EF had a significantly higher risk of the primary end point than patients without FMR (hazard ratio [HR] 1.60; 95% confidence interval [CI] 1.12 to 2.29; p = 0.010 and HR 1.98; 95% CI 1.30 to 3.01; p = 0.001, respectively). In patients with reduced EF with an ischemic origin, only moderate to severe FMR was associated with a significantly higher risk of the primary end point (HR 1.67; 95% CI 1.11 to 2.50; p = 0.014). In the nonischemic group, there was no significant association between FMR and the primary end point in patients with either a preserved or reduced EF. In conclusion, among patients with acute decompensated HF with a preserved or reduced EF, the association of FMR with adverse outcomes may differ between patients who had an ischemic or nonischemic origin of HF.

Original languageEnglish
Pages (from-to)809-816
Number of pages8
JournalAmerican Journal of Cardiology
Volume120
Issue number5
DOIs
Publication statusPublished - Sep 1 2017

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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