Factors associated with the election of treatment options for mitral regurgitation in elderly inpatients
10.3760/cma.j.issn.0254-9026.2018.05.003
- VernacularTitle:老年二尖瓣反流住院患者治疗方案选择的相关因素分析
- Author:
Ruiqi ZHUGE
1
;
Mingzi ZHANG
;
Xiaopei HOU
;
Xiling QI
;
Yongjian WU
Author Information
1. 100037,北京协和医学院中国医学科学院阜外医院心内科
- Keywords:
Mitral valve insufficiency;
Stroke volume;
Risk factors
- From:
Chinese Journal of Geriatrics
2018;37(5):496-500
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the clinical characteristics and current management strategy and to examine the factors to be considered in the selection of treatment options for mitral regurgitation (MR) in elderly inpatients.Methods Elderly patients(≥60years old)who had been diagnosed with moderate to severe MR by transthoracic echocardiography and hospitalized from May 1,2014 to April 30,2015were included in this study (N=680).Patients were grouped according to therapy:the surgery group (n=372) and the medication group (n=308).Data at baseline including medical history and echocardiography were collected for comparison between the two groups and for analysis of factors associated with treatment choice.Results Of the 680 patients with moderate to severe MR,45.3％ were treated with medication.Compared with the surgery group,patients in the medication group were older,with a lower prevalence of primary MR,a higher prevalence of coronary heart disease and higher Euroscore-Ⅱ scores (all P＜0.01).Furthermore,the medication group had a lower prevalence of moderate MR(75/308 or 24.4％ vs.200/372 or 53.8％,P＜ 0.01),a lower left ventricular ejection fraction (47.8 ± 16.1) ％ vs (61.5 ± 9.2)％(P＜0.01),and a larger left ventricular end diastolic diameter(59.2±11.4)mmw (55.8±8.8)mm (P＜ 0.01).Besides,multivariable analysis revealed that regurgitation grade,left ventricular ejection fraction,multiple valve disease,age,and diabetes were correlated with therapy decisions(OR=62.067,1.089,4.791,0.879 and 0.414,respectively,P＜0.01 or P＜0.05).Conclusions Old age,impaired left ventricular ejection fraction,low regurgitation grade,diabetes,and absence of multiple valves are the most salientfactors for which surgery should not be selected.
