Mitral regurgitation in acute decompensated HF varies by LVE
In acute decompensated HF, moderate or severe mitral regurgitation occurred in nearly half of patients with ejection fraction below 50%, and its overall prevalence in this population varied by race/ethnicity and sex, researchers reported.

This study investigates the prevalence and prognostic significance of mitral regurgitation (MR) in acute decompensated heart failure (ADHF) patients. Few studies characterize the burden of MR in heart failure.

The ARIC (Atherosclerosis Risk In Communities) study surveilled ADHF hospitalizations for residents more than 55 years of age in 4 U.S. communities. ADHF cases were stratified by left ventricular ejection fraction (LVEF): less than 50% and more than 50%. Odds of moderate or severe MR in patients with varying sex and race, and odds of 1-year mortality in those with higher MR severity were estimated using multivariable logistic regression.

Results
-- There were 17,931 weighted ADHF hospitalizations of which 49.2% had an LVEF less than 50% and 50.8% an LVEF more than 50%.

-- Moderate or severe MR prevalence was 44.5% in those with an LVEF less than 50% and 27.5% in those with an LVEF more than 50%.

-- Moderate or severe MR was more likely in females than males regardless of LVEF; LVEF less than 50%, LVEF more than 50%.

-- Among hospitalizations with an LVEF more than 50%, moderate or severe MR was less likely in blacks than whites.

-- Higher MR severity was independently associated with increased 1-year mortality in those with an LVEF less than 50%.

Conclusively, patients with ADHF have a significant MR burden that varies with sex and race. In ADHF patients with an LVEF less than 50%, higher MR severity is associated with excess 1-year mortality.

Source: https://www.jacc.org/doi/abs/10.1016/j.jchf.2020.09.015
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