Valvular & structural heart disease
Indexing left ventricular end‐systolic dimension to body size: Association with mortality in patients with degenerative mitral regurgitation
Main finding · Mortality under conservative managementResult — go to the resultAdjusted hazard ratio 1.41 95% CI 1.15–1.75Authors' conclusion
In severe DMR due to flail leaflets, LVESDi is a marker of risk additive and incremental to LVESD.
Study context
- Population
- Patients with degenerative mitral regurgitation due to flail leaflets, tertiary centres in Europe and the US
- Participants
- 2,753 patients
- Exposure
- LVESD index (LVESDi) ≥20 mm/m² vs LVESDi <20 mm/m²
- Outcome
- Mortality after diagnosis under conservative management
Methodological detailsmulticentre, consecutive patients, tertiary centres in Europe and the US
- Multicentre
- Consecutive patients
- Tertiary centres in Europe and the US
Main finding
Mortality under conservative management
Adjusted hazard ratio
1.41
95% CI 1.15–1.75
LVESDi ≥20 mm/m²vs LVESDi <20 mm/m²
adjusted HR 1.41 (95% CI 1.15–1.75)
As reported in the abstract
- 10-year survival lower with LVESDi ≥20 mm/m² than <20 mm/m², irrespective of management type
- P < 0.001
- Optimal LVESDi cut-off for mortality prediction (mm/m²)
- 20
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| Mortality under conservative and surgical management | 1.34 (1.17–1.54) | |
| 0.512Adjusted hazard ratio (log scale) |
Postoperative mortality in patients who underwent surgery
- LVESDi remained associated with poorer postoperative outcome
Incremental predictive value
- LVESDi showed higher incremental predictive value over the baseline model than LV end-systolic diameter (LVESD)
Subgroups of patients with degenerative mitral regurgitation (DMR)
- Association between LVESDi ≥20 mm/m² and outcome consistent across subgroups
Original publication
Indexing left ventricular end‐systolic dimension to body size: Association with mortality in patients with degenerative mitral regurgitation. Eur J Heart Fail. Published 22 July 2024. doi:10.
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