Valvular & structural heart disease
Reappraisal of the Concept and Implications of Pulmonary Hypertension in Degenerative Mitral Regurgitation
An erratum to this article was published (JACC Cardiovasc Imaging, Sep 2024 ↗)
Authors' conclusion
This large international registry, with prospectively quantified DMR and SPAP, demonstrates a Doppler-defined PHTN impact on mortality, independent of DMR severity.
Study context
- Population
- Consecutive patients with isolated ≥ moderate-to-severe degenerative mitral regurgitation
- Participants
- 3,712 patients
- Exposure
- Severe and moderate pulmonary hypertension vs no pulmonary hypertension in degenerative mitral regurgitation (DMR)
- Severe pulmonary hypertension (sPHTN)n = 916
- Moderate pulmonary hypertension (mPHTN)n = 1,128
- no-PHTNn = 1,668reference
- Outcome
- Mortality (under medical management)
Methodological detailsmulticentre, prospective quantification at diagnosis, consecutive patients
- Multicentre
- Prospective quantification at diagnosis
- Consecutive patients
Main finding
As reported in the abstract
Mortality
Each group vs no-PHTNAdjusted hazard ratio (95% CI)P value
sPHTN
1.65(1.24–2.20)
P ≤ 0.005mPHTN
1.44(1.11–1.85)
P ≤ 0.005Observational data: associations, not effects.
Further findings
Incremental prognostic value (nested models)
- Incremental prognostic value of mPHTN and sPHTN
- P < 0.0001
Postoperative mortality
- Excess mortality abolished in mPHTN
- P ≥ 0.30
- Excess mortality only abated in sPHTN
Original publication
Reappraisal of the Concept and Implications of Pulmonary Hypertension in Degenerative Mitral Regurgitation. JACC Cardiovasc Imaging. Published 26 June 2024. doi:10.
Summarised from the published abstract; every number is checked against it