title: Prevalence and the long-term prognosis of functional mitral regurgitation in Japanese patients with symptomatic heart failure.
abstract: Functional mitral regurgitation (FMR) is a common and critical condition in patients with heart failure (HF); however, the prevalence and clinical outcome of FMR in Japanese real-world clinical practice remain unclear. Within a single hospital-based cohort in the Shinken Database 2004-2011, which comprised all new patients (n = 17,517) who visited the Cardiovascular Institute, we followed symptomatic HF patients. A total of 1,701 patients were included: 104 FMR patients (who had moderate to severe FMR) and 1,597 non-FMR patients (who had none or mild FMR). FMR patients had lower rates of hypertension and dyslipidemia, but higher rates of dilated cardiomyopathy, atrial fibrillation, and New York Heart Association functional class III/IV. FMR patients had higher levels of brain natriuretic peptide and lower left ventricular function. Use of cardiovascular drugs was more common among FMR patients. Kaplan-Meier curves revealed that the incidences of all-cause death, cardiovascular death, and admission for HF were significantly higher in FMR patients. The adjusted Cox regression analysis showed that significant FMR was associated with higher incidences of all-cause death [hazard ratio (HR) 2.179, 95 % confidence interval (CI) 1.266-3.751; P = 0.005], cardiovascular death (HR 2.371, 95 % CI 1.157-4.858; P = 0.018), and admission for HF (HR 1.819, 95 % CI 1.133-2.920; P = 0.013). FMR was common in Japanese symptomatic HF patients and was associated with adverse long-term outcomes. Establishing optimal therapeutic strategies for FMR is warranted.
authors.affiliation: The Department of Cardiovascular Medicine, The Cardiovascular Institute, 3-2-19 Nishiazabu, Minato-ku, Tokyo, 106-0031, Japan, h-kaneko@cvi.or.jp.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kaneko
authors.forename: Shinya
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tokuhisa
authors.initials: T
authors.lastname: Uejima
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kano
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Matsuno
authors.forename: Takayuki
authors.initials: T
authors.lastname: Otsuka
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Junji
authors.initials: J
authors.lastname: Yajima
authors.forename: Akira
authors.initials: A
authors.lastname: Koike
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagashima
authors.forename: Hajime
authors.initials: H
authors.lastname: Kirigaya
authors.forename: Koichi
authors.initials: K
authors.lastname: Sagara
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanabe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sawada
authors.forename: Tadanori
authors.initials: T
authors.lastname: Aizawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications; D002311:Cardiomyopathy, Dilated / Q000150:complications; D002423:Cause of Death; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D016277:Ventricular Function, Left