Analysis of Clinical Features and Factors Related to Treatment Decision for Hospitalized Patients With Mitral Regurgitation
10.3969/j.issn.1000-3614.2018.06.018
- VernacularTitle:二尖瓣反流住院患者的临床特征及治疗选择因素分析
- Author:
Rui-Qi ZHUGE
1
;
Ming-Zi ZHANG
;
Xiao-Pei HOU
;
Zhen-Yan ZHAO
;
Yong-Jian WU
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 心内科
- Keywords:
Mitral valve insufficiency;
Diseasefeatures;
Clinical therapeutic strategies
- From:
Chinese Circulation Journal
2018;33(6):606-610
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To observe the clinical features and factorsrelated to treatment decision for hospitalizedpatients with mitral regurgitation (MR). Methods:A total of 3 450 consecutivepatients with transthoracic echocardiography (TTE) confirmed moderate to severe MR admitted in our hospital from 2014-01-01 to 2015-12-31 were enrolled. Base on therapeutic method, the patients were divided into 2 groups:Surgery group, n=1 845 and Medication group, n=1 605. The baseline data including TTE results were collected, clinical features were compared between 2 groups and factors related to treatment decision were analyzed. Results:Mean age of this patient cohort was (54.8±13.8) years including 26.99% (931/3 450) patients aged ≥65 years. The most common etiology was primary MR, 324 (9.39%) patients were asymptomatic at admission and decreased left ventricular ejection fraction (LVEF) was evidenced in 55.28% (1 907) patients. Total in-hospital mortality was 0.75% (26). Compared with Medication group, the patients in Surgery group were younger ([52.65±12.01] years vs [57.39±15.25] years), prevalence of severe MR (56.69% vs 26.79%) and primary MR (89.49% vs 39.00%), as well as LVEF value ([61.62±9.20] % vs [48.00±17.53] %) were higher (all P＜0.001).Logistic regression analysis indicated that age (OR=0.561, 95% CI 0.503-0.627), MR etiology (OR=3.062, 95% CI 2.565-3.654), MR grade (OR=0.103, 95% CI 0.085-0.126) and LVEF (OR=2.478, 95% CI 2.147-2.860) were the determinants for treatmentdecision making in hospitalized patients with moderate to severe MR. Conclusions:In this patient cohort, there are considerable proportion of aged patients with moderate to severe MR. Primary MRis the major etiology. 46.52% patients received conservative therpay instead of surgery, older age,secondary MR, moderate MR and decreased LVEF are the major reasons for choosing conservative therapy in this patient cohort.
