Baseline mitral regurgitation predicts outcome in patients referred for dobutamine stress echocardiography

O'Driscoll, J., Gargallo-Fernandez, P., Araco, M., Perez-Lopez, M. and Sharma, R. (2017) Baseline mitral regurgitation predicts outcome in patients referred for dobutamine stress echocardiography. International Journal of Cardiovascular Imaging. ISSN 1569-5794. (In Press)

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Abstract

Purpose: A number of parameters recorded during dobutamine stress echocardiography (DSE) are associated with worse outcome. However, the relative importance of baseline mitral regurgitation (MR) is unknown. The aim of this study was to assess the prevalence and associated implications of functional MR with long-term mortality in a large cohort of patients referred for DSE.

Methods: 6745 patients (mean age 64.9±12.2 years) were studied. Demographic, baseline and peak DSE data were collected. All-cause mortality was retrospectively analyzed. DSE was successfully completed in all patients with no adverse outcomes.

Results: MR was present in 1019 (15.1%) patients. During a mean follow up of 5.1±1.8 years, 1642 (24.3%) patients died and MR was significantly associated with increased all-cause mortality (p<0.001). With Kaplan-Meier analysis, survival was significantly worse for patients with moderate and severe MR (p<0.001). With multivariate Cox regression analysis, moderate and severe MR (HR 2.78; 95% CI 2.17 - 3.57; and HR 3.62; 95% CI 2.89 - 4.53, respectively) were independently associated with all-cause mortality. The addition of MR to C statistic models significantly improved discrimination.

Conclusions: MR is associated with all-cause mortality and adds incremental prognostic information among patients referred for DSE. The presence of MR should be taken into account when evaluating the prognostic significance of DSE results.

Item Type: Article
Subjects: Q Science > QP Physiology
R Medicine
Divisions: Faculty of Social and Applied Sciences > School of Human and Life Sciences
Depositing User: Dr Jamie O'Driscoll
Date Deposited: 10 Jul 2017 16:10
Last Modified: 05 Aug 2017 04:41
URI: https://create.canterbury.ac.uk/id/eprint/16036

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Last edited: 29/06/2016 12:23:00