Mitral Annular Tissue Velocity Predicts Survival in Patients With Primary Mitral Regurgitation
- Author:
You-Jung CHOI
1
;
Chan Soon PARK
;
Tae-Min RHEE
;
Hyun-Jung LEE
;
Hong-Mi CHOI
;
In-Chang HWANG
;
Jun-Bean PARK
;
Yeonyee E. YOON
;
Jin Oh NA
;
Hyung-Kwan KIM
;
Yong-Jin KIM
;
Goo-Yeong CHO
;
Dae-Won SOHN
;
Seung-Pyo LEE
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2024;54(6):311-322
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:Early diastolic mitral annular tissue (e’) velocity is a commonly used marker of left ventricular (LV) diastolic function. This study aimed to investigate the prognostic implications of e’ velocity in patients with mitral regurgitation (MR).
Methods:This retrospective cohort study included 1,536 consecutive patients aged <65 years with moderate or severe chronic primary MR diagnosed between 2009 and 2018. The primary and secondary outcomes were all-cause and cardiovascular mortality, respectively.According to the current guidelines, the cut-off value of e’ velocity was defined as 7 cm/s.
Results:A total of 404 individuals were enrolled (median age, 51.0 years; 64.1% male; 47.8% severe MR). During a median 6.0-year follow-up, there were 40 all-cause mortality and 16 cardiovascular deaths. Multivariate analysis revealed a significant association between e’ velocity and all-cause death (adjusted hazard ratio [aHR], 0.770; 95% confidence interval [CI], 0.634–0.935; p=0.008) and cardiovascular death (aHR, 0.690; 95% CI, 0.477–0.998;p=0.049). Abnormal e’ velocity (≤7 cm/s) independently predicted all-cause death (aHR, 2.467; 95% CI, 1.170–5.200; p=0.018) and cardiovascular death (aHR, 5.021; 95% CI, 1.189–21.211; p=0.028), regardless of symptoms, LV dimension and ejection fraction. Subgroup analysis according to sex, MR severity, mitral valve replacement/repair, and symptoms, showed no significant interactions. Including e’ velocity in the 10-year risk score improved reclassification for mortality (net reclassification improvement [NRI], 0.154; 95% CI, 0.308– 0.910; p<0.001) and cardiovascular death (NRI, 1.018; 95% CI, 0.680–1.356; p<0.001).
Conclusions:In patients aged <65 years with primary MR, e’ velocity served as an independent predictor of all-cause and cardiovascular deaths.
