Prognostic value of exercise stress echocardiography in patients with secondary mitral regurgitation: a long-term follow-up study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10-29

AUTHORS

Tomomi Suzuki, Masaki Izumo, Kengo Suzuki, Dan Koto, Maya Tsukahara, Kanako Teramoto, Yukio Sato, Mika Watanabe, Kei Mizukoshi, Ryo Kamijima, Manabu Takai, Seisyou Kou, Tomoo Harada, Sachihiko Nobuoka, Yoshihiro J. Akashi

ABSTRACT

BackgroundSecondary mitral regurgitation (MR) remains a challenging problem in the diagnosis and treatment of patients with heart failure. Although it is well known that secondary MR is dynamic, the impact of the severity of MR during exercise on long-term outcome has not been fully evaluated. The aim of the present study was to investigate the prognostic value of exercise stress echocardiography (ESE) in patients with secondary MR.MethodsThis prospective study included 118 consecutive patients with secondary MR and left ventricular dysfunction (mean ejection fraction at rest: 38 ± 14%) who underwent semi-supine ESE. Their major cardiovascular events (MACE) including cardiac death were followed up for a median of 41.7 (range: 6–128) months.ResultsMR significantly increased from rest to exercise (effective regurgitant orifice: 0.18 ± 0.09 vs. 0.25 ± 0.12 cm2, P < 0.001). The prevalence of severe MR was higher during exercise than those at rest (37% vs. 56%, P < 0.001). During follow-up, MACE occurred in 49 patients (41.5%) including 12 cardiac deaths. Cox proportional-hazard multivariate analysis revealed that older age and MR severity during exercise were significantly associated with increased risk of MACE (hazard ratio: 1.04 and 8.4, respectively, both P < 0.05).ConclusionsESE provides prognostic information in patients with secondary MR that is useful for predicting long-term outcome. More... »

PAGES

147-156

References to SciGraph publications

  • 2016-01-13. Exercise echocardiography for structural heart disease in JOURNAL OF ECHOCARDIOGRAPHY
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s12574-018-0404-6

    DOI

    http://dx.doi.org/10.1007/s12574-018-0404-6

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    https://app.dimensions.ai/details/publication/pub.1107910617

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30374661


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    21 schema:description BackgroundSecondary mitral regurgitation (MR) remains a challenging problem in the diagnosis and treatment of patients with heart failure. Although it is well known that secondary MR is dynamic, the impact of the severity of MR during exercise on long-term outcome has not been fully evaluated. The aim of the present study was to investigate the prognostic value of exercise stress echocardiography (ESE) in patients with secondary MR.MethodsThis prospective study included 118 consecutive patients with secondary MR and left ventricular dysfunction (mean ejection fraction at rest: 38 ± 14%) who underwent semi-supine ESE. Their major cardiovascular events (MACE) including cardiac death were followed up for a median of 41.7 (range: 6–128) months.ResultsMR significantly increased from rest to exercise (effective regurgitant orifice: 0.18 ± 0.09 vs. 0.25 ± 0.12 cm2, P < 0.001). The prevalence of severe MR was higher during exercise than those at rest (37% vs. 56%, P < 0.001). During follow-up, MACE occurred in 49 patients (41.5%) including 12 cardiac deaths. Cox proportional-hazard multivariate analysis revealed that older age and MR severity during exercise were significantly associated with increased risk of MACE (hazard ratio: 1.04 and 8.4, respectively, both P < 0.05).ConclusionsESE provides prognostic information in patients with secondary MR that is useful for predicting long-term outcome.
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    28 MethodsThis prospective study
    29 ResultsMR
    30 age
    31 aim
    32 analysis
    33 cardiac death
    34 cardiovascular events
    35 challenging problem
    36 consecutive patients
    37 death
    38 diagnosis
    39 dysfunction
    40 echocardiography
    41 events
    42 exercise
    43 exercise stress echocardiography
    44 failure
    45 follow
    46 heart failure
    47 impact
    48 information
    49 long-term follow
    50 long-term outcomes
    51 major cardiovascular events
    52 median
    53 mitral regurgitation
    54 months
    55 multivariate analysis
    56 older age
    57 outcomes
    58 patients
    59 present study
    60 prevalence
    61 problem
    62 prognostic information
    63 prognostic value
    64 proportional hazard multivariate analysis
    65 prospective study
    66 regurgitation
    67 rest
    68 risk
    69 risk of MACE
    70 secondary mitral regurgitation
    71 severe mitral regurgitation
    72 severity
    73 severity of MR
    74 stress echocardiography
    75 study
    76 treatment
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