Bronx, NY: Study on Functional Mitral Regurgitation

A recent study has revealed that more than half of patients presenting with acute decompensated heart failure have at least moderate functional mitral regurgitation (FMR) -- associated with increased readmission rates and mortality.

Further, the presence of higher severity functional mitral regurgitation (FMR) on admission for acute decompensated heart failure has long-term prognostic significance. The study appears in the Journal of the American Heart Association (JAHA).

In patients with chronic heart failure and left ventricular systolic dysfunction, FMR has emerged as a therapeutic target. However, the significance of FMR in acute decompensated heart failure is not clear. Therefore, Ulrich P. Jorde, Albert Einstein College of Medicine, Bronx, NY, and colleagues aimed to systematically investigate the prevalence and clinical significance of FMR on admission in patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction.

For this purpose, the researchers conducted a single‐center, retrospective review of patients admitted with acute decompensated heart failure and left ventricular systolic dysfunction. They were divided into 3 groups of FMR: none/mild, moderate, and moderate‐to‐severe/severe FMR.

The primary outcome was 1‐year post‐discharge all‐cause mortality. The researchers also compared these groups for 6‐month heart failure hospitalization rates. Out of 2303 patients, 39% (896) were women.

Key Findings

• Median left ventricular ejection fraction was 25%.
• 20% of patients had moderate‐to‐severe/severe FMR, which was independently associated with 1‐year all‐cause mortality.
• Moderate or worse FMR was found in 53% of patients and was independently associated with 6‐month heart failure hospitalization.
• Female sex was independently associated with higher severity of FMR.

"There is a need to undertake intensified post‐discharge follow‐up to eliminate FMR amenable to pharmacological therapy and enable timely and appropriate intervention for persistent FMR," wrote the authors. "Further studies are required to examine sex‐related disparities in FMR."

Reference

The study titled, "Severity of Functional Mitral Regurgitation on Admission for Acute Decompensated Heart Failure Predicts Long‐Term Risk of Rehospitalization and Death," was published in the Journal of the American Heart Association (JAHA).

DOI: https://doi.org/10.1161/JAHA.121.022908