Long-term follow-up of mitral valve regurgitation--importance of mitral valve pathology and left ventricular function on survival.
BACKGROUND
Timing of surgery for mitral regurgitation (MR) is one of the more difficult decisions for the practicing cardiologist.


RESULTS
In order to determine useful clinical cut-offs, we investigated the influence of baseline echocardiographic predictors for survival in a long-time follow-up cohort. Data from 144 patients with MR were collected between 1989 and 1993. Five-year mortality for MR patients was 30% compared to 13% for age- and sex matched controls (p<0.001). Each mm increase in left ventricular end systolic diameter (LVESD increased mortality with 2.5% (p<0.05) and each percent decrease in ejection fraction (EF) increased mortality with 1.8% (p<0.05). These effects were not linear and this material suggests cut-off points for LVESD to be 40 mm and EF 50%. Degree of MR did not correlate with survival, but patients with severe MR were operated more often than those with moderate MR. Patients with functional MR had reduced survival compared to patients with structural MR (p<0.01).


CONCLUSIONS
MR is a disease with greatly increased mortality and these data suggest a more aggressive approach to surgery.
Lindmark
Krister
K
Department of Cardiology, Heart Center, Umeå University Hospital, SE-901 85 Umeå, Sweden. krister.lindmark@vll.se
Söderberg
Stefan
S
Teien
Dag
D
Näslund
Ulf
U
D000368:Aged; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology