Heart failure & cardiomyopathies
Exercise-Induced Dynamic Mitral Regurgitation is Associated with Outcomes in Patients with Ischaemic Cardiomyopathy
Authors' conclusion
The haemodynamic changes provoked by isometric exercise unmasked dynamic severe MR in a significant number of patients with non-severe MR at rest. These data may have implications for therapeutic decision-making in symptomatic patients with non-severe MR at rest.
Study context
- Population
- Heart failure patients with ischaemic cardiomyopathy and at least mild mitral regurgitation (MR) who underwent handgrip echocardiographypatients with ischaemic cardiomyopathy included (age 75 ± 10 years, 21% female, LVEF 35 ± 9%)
- Participants
- 133 patients
- Comparison
- Prognostic impact of dynamic MR using isometric handgrip exercise
- Dynamic MRn = Twenty-five
- Outcome
- MR severity at rest
- Follow-up
- At rest
Methodological detailssingle-centre (University Hospital Duesseldorf), January 2018 to September 2021, 1-year follow-up
- Single-centre (University Hospital Duesseldorf)
- January 2018 to September 2021
- 1-year follow-up
Main finding
As reported in the abstract
Mild MR
70 patients
53%
Moderate MR
54 patients
41%
Severe MR
9 patients
7%
Further findings
Predictors of the combined endpoint (all-cause mortality, heart failure hospitalization, mitral valve surgery/interventions, ventricular assist device implantation and heart transplantation) · 1 year
| HR (CI) | ||
|---|---|---|
| MR severity during exerciseMultivariate analysis | 1.998 (1.367–2.938) | |
| Exercise TAPSEMultivariate analysis | 0.913 (0.853–0.973) | |
| 0.20.5125Hazard ratio (log scale) |
Dynamic severe MR during handgrip exercise
- Patients with non-severe MR at rest who developed severe MR during handgrip exercise
- Twenty-five patients (20%)
Rest characteristics of patients with dynamic MR
- Larger left atrial dimensions, increased wall motion score index and larger tenting area at rest
Original publication
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