Etiologic spectrum and clinical features of mitral regurgitation in a Spanish population.
OBJECTIVE
The study aim was to investigate the etiologic spectrum of at least moderate mitral regurgitation (MR) in patients at a tertiary care center in a Spanish region.


METHODS
All patients referred for echocardiography with moderate or severe MR, assessed according to the guidelines of the American Society of Echocardiography, were included prospectively in the study.


RESULTS
Between October 2006 and February 2008, a total of 276 patients (157 females, 119 males; mean age 61 +/- 20 years) were enrolled into the study. At the time of evaluation, 67% of the patients were outpatients and the remainder were hospitalized. The NYHA functional class was III-IV in 31% of patients. The main echocardiographic data were: color flow jet area 11 +/- 5 cm2, vena contracta 6.7 +/- 1.9 mm, effective regurgitant orifice area 0.46 +/- 0.28 cm2, left ventricular diastolic and systolic diameters 58 +/- 10 mm and 39 +/- 12 mm, respectively, left ventricular ejection fraction 0.55 +/- 0.19, and pulmonary artery systolic pressure 39 +/- 16 mmHg. The MR was degenerative in 42% of patients, rheumatic in 22%, functional due to idiopathic dilated cardiomyopathy in 18%, functional due to ischemic cardiomyopathy in 7%, congenital in 7%, and had other causes in 4%.


CONCLUSIONS
Among this Spanish population, the majority of the moderate or severe MR encountered was organic, with degenerative mitral disease as the most common etiology. Functional regurgitation was present in a significant proportion of patients, with idiopathic dilated cardiomyopathy being the most frequent cause.
Department of Cardiology, Reina Sofia Hospital, Córdoba, Spain. franciscotoledan@gmail.com
Francisco
F
Toledano
Manuel
M
Crespín
Martín Ruíz
MR
Ortiz
Dolores
D
Mesa
Elías
E
Romo
Mónica
M
Delgado
José
J
Suárez de Lezo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000150:complications; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000150:complications; D010045:Outpatients / Q000706:statistics & numerical data; D011446:Prospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology