title: Prognostic Impact of Functional Mitral Regurgitation in Patients Admitted With Acute Decompensated Heart Failure.
abstract: BACKGROUND
  Functional mitral regurgitation (FMR) is a common complication of heart failure (HF) and worsens in acute decompensation. It is unclear whether FMR on admission or discharge determines the outcome. This study aimed to elucidate the prognostic significance of FMR on admission or discharge in patients admitted with acute decompensated HF.
  
  
  RESULTS
  From 2006 to 2009, 349 patients admitted with acute decompensated HF were enrolled. They were followed with the composite endpoint of all-cause death and hospitalization for HF; 74 (21%) died and 113 (32%) developed the composite endpoint during 2.1±1.3 years. Moderate/severe FMR at discharge was associated with the composite endpoint (P=0.001), whereas that on admission was not. Multivariate Cox proportional hazard analysis showed that moderate/severe FMR (hazard ratio [95% confidence interval] =1.70 [1.03-2.73] P=0.04), logBNP, and NYHA class III/IV at discharge were independent determinants of the outcome. Moderate/severe FMR at discharge with BNP ≥200 pg/ml was prognostic, but BNP <200 pg/ml was no longer prognostic.
  
  
  CONCLUSIONS
  Residual moderate/severe FMR after medical therapy for acute decompensated HF was associated with poor outcome, suggesting a potential target for further treatment of HF.
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Wada
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ohara
authors.forename: Akira
authors.initials: A
authors.lastname: Funada
authors.forename: Takuya
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sugano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000628:therapy; D015996:Survival Rate