Prevalence and Prognostic Significance of Mitral Regurgitation in Acute Decompensated Heart Failure: The ARIC Study

Sameer Arora, Krishan Sivaraj, Michael Hendrickson, Patricia P. Chang, Thelsa Weickert, Arman Qamar, Muthiah Vaduganathan, Melissa C. Caughey, Ambarish Pandey, Matthew A. Cavender, Wayne Rosamond, John P. Vavalle

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objectives: This study investigates the prevalence and prognostic significance of mitral regurgitation (MR) in acute decompensated heart failure (ADHF) patients. Background: Few studies characterize the burden of MR in heart failure. Methods: The ARIC (Atherosclerosis Risk In Communities) study surveilled ADHF hospitalizations for residents ≥55 years of age in 4 U.S. communities. ADHF cases were stratified by left ventricular ejection fraction (LVEF): <50% and ≥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: From 2005 to 2014, there were 17,931 weighted ADHF hospitalizations of which 49.2% had an LVEF <50% and 50.8% an LVEF ≥50%. Moderate or severe MR prevalence was 44.5% in those with an LVEF <50% and 27.5% in those with an LVEF ≥50%. Moderate or severe MR was more likely in females than males regardless of LVEF; LVEF <50% (odds ratio [OR]: 1.21 [95% confidence interval (CI): 1.11 to 1.33]), LVEF ≥50% (OR: 1.52 [95% CI: 1.36 to 1.69]). Among hospitalizations with an LVEF ≥50%, moderate or severe MR was less likely in blacks than whites (OR: 0.72 [95% CI: 0.64 to 0.82]). Higher MR severity was independently associated with increased 1-year mortality in those with an LVEF <50% (OR: 1.30 [95% CI: 1.16 to 1.45]). Conclusions: Patients with ADHF have a significant MR burden that varies with sex and race. In ADHF patients with an LVEF <50%, higher MR severity is associated with excess 1-year mortality.

Original languageEnglish (US)
Pages (from-to)179-189
Number of pages11
JournalJACC: Heart Failure
Volume9
Issue number3
DOIs
StatePublished - Mar 2021

Keywords

  • ADHF
  • Atherosclerosis Risk In Communities study
  • HF
  • MR
  • mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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