Valvular & structural heart disease
Degenerative mitral stenosis by echocardiography: presentation and outcome
Authors' conclusion
DMS is a condition of the elderly potentially resulting in severe mitral obstruction and haemodynamic alterations. However, DMS is frequently associated with severe comorbidities imparting considerable mortality following diagnosis, whereas DMS severity is a weak (albeit independent) determinant of mortality.
Study context
- Population
- Patients diagnosed with degenerative mitral stenosis (diastolic mean gradient ≥ 5 mmHg) by Doppler echocardiography in routine practice, 2003–2014; overt mitral annular/valvular degenerative calcification without rheumatic involvement75 ± 12 years, 67% women
- Participants
- 2,937 patients
- Exposure
- Mild Degenerative Mitral Stenosis (DMS) vs Moderate DMS vs Severe DMS
- Outcome
- Survival after DMS diagnosis
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Mortality
One-year mortality
22%
Long-term mortality at 5 years
56%
Observational data: associations, not effects.
Further findings
One-year mortality by DMS severity, without anaemia
| Outcome | Adjusted HR (CI) | P value | |
|---|---|---|---|
| Long-term mortality by DMS severity, without anaemiaModerate DMSvs Mild DMS | 1.30 (1.19–1.42) | P < 0.0001 | |
| Long-term mortality by DMS severity, without anaemiaSevere DMSvs Mild DMS | 1.63 (1.34–1.98) | P < 0.0001 | |
| 0.512Adjusted hazard ratio (log scale) |
- One-year mortality by DMS severity, without anaemia: P < 0.0004
- Long-term mortality by DMS severity, without anaemia: with anaemia P = 0.90
One-year mortality, with anaemia
- Mortality irrespective of DMS severity
- 42%
- P = 0.99
Baseline characteristics
- Mean gradient (mmHg)
- 6.5 ± 2.4
- DMS mild / moderate / severe
- 50% / 44% / 6%
- Left atrial volume (mL/m²)
- 52 ± 23
- Pulmonary pressure (mmHg)
- 49 ± 16
- EF
- 61 ± 13%
- Hypertension / coronary disease / HF
- 74% / 58% / 52%
- Haemoglobin (g/dL)
- 11.3 ± 1.8
- Creatinine (mg/dL)
- 1.5 ± 1.4
Original publication
Degenerative mitral stenosis by echocardiography: presentation and outcome. Eur Heart J Cardiovasc Imaging. Published 20 September 2024. doi:10.
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