ABSTRACT
Objectives:To observe the clinical features and factorsrelated to treatment decision for hospitalizedpatients with mitral regurgitation (MR). Methods:A total of 3 450 consecutivepatients with transthoracic echocardiography (TTE) confirmed moderate to severe MR admitted in our hospital from 2014-01-01 to 2015-12-31 were enrolled. Base on therapeutic method, the patients were divided into 2 groups:Surgery group, n=1 845 and Medication group, n=1 605. The baseline data including TTE results were collected, clinical features were compared between 2 groups and factors related to treatment decision were analyzed. Results:Mean age of this patient cohort was (54.8±13.8) years including 26.99% (931/3 450) patients aged ≥65 years. The most common etiology was primary MR, 324 (9.39%) patients were asymptomatic at admission and decreased left ventricular ejection fraction (LVEF) was evidenced in 55.28% (1 907) patients. Total in-hospital mortality was 0.75% (26). Compared with Medication group, the patients in Surgery group were younger ([52.65±12.01] years vs [57.39±15.25] years), prevalence of severe MR (56.69% vs 26.79%) and primary MR (89.49% vs 39.00%), as well as LVEF value ([61.62±9.20] % vs [48.00±17.53] %) were higher (all P＜0.001).Logistic regression analysis indicated that age (OR=0.561, 95% CI 0.503-0.627), MR etiology (OR=3.062, 95% CI 2.565-3.654), MR grade (OR=0.103, 95% CI 0.085-0.126) and LVEF (OR=2.478, 95% CI 2.147-2.860) were the determinants for treatmentdecision making in hospitalized patients with moderate to severe MR. Conclusions:In this patient cohort, there are considerable proportion of aged patients with moderate to severe MR. Primary MRis the major etiology. 46.52% patients received conservative therpay instead of surgery, older age,secondary MR, moderate MR and decreased LVEF are the major reasons for choosing conservative therapy in this patient cohort.
ABSTRACT
Objective: To summarize the clinical features and treatment status for elderly in-hospital patients with mitral regurgitation (MR). Methods: A single center retrospective study was conducted in 1 741 patients admitted in our hospital from 2014-05-01 to 2015-04-30 with echocardiography confirmed moderate to severe MR. The patients were divided into 2 groups: Elderly group, n=680(39.06%)patients≥60 years of age and Non-elderly group,n=1 061(60.94%)patients<60 years.Clinical features and treatment status were studied and compared between 2 groups. Results: The mean age in Elderly group was (66.98±5.94) years and the most common type was degenerative MR (41.18%). Compared with Non-elderly group, Elderly group had more patients combining coronary artery disease (37.79% vs 17.43% ), more risk factors of atherosclerosis such as hypertension (45.44% vs 25.17%), diabetes (19.56% vs 8.48%) and hyperglycemia (35.29% vs 19.51%) all P<0.05; Elderly group had the higher EuroSCORE Ⅱ score (5.54±2.42) vs (3.15±1.66), greater left ventricular end diastolic diameter (57.72±12.37) mm vs (57.33±10.19) mm and less patients combining multiple valve disease (35.59% vs 40.81%), less patients received surgical treatment (54.71% vs 63.9%), all P<0.05. The surgery procedures (mitral valve replacement or mitral-plasty) were similar between 2 groups; compared with Non-elderly group, Elderly group had the higher application rate of bio-prosthetic valve (53.88% vs 18.67%), P<0.001. Conclusion: About 40% in-hospital moderate to severe MR patients were the elderly crowd, the most common pathogenesis was degenerative changes which leaded the higher incidences of cardiac complications, worse cardiac function and the higher risk scores for surgical treatment, there were less patients received surgery.