RESUMO
PURPOSE: To describe the etiology and to document the course of severe mitral regurgitation (MR). METHODS: Prospective registry of 272 patients diagnosed with chronic severe MR in an echocardiographic study. RESULTS: Mean age was 70.2 +/- 13.8 years and 143 patients were women (53%). The most frequent causes of regurgitation were rheumatic disease (72 patients; 26%), ischemic etiology (58; 21%), valve prolapse (57; 21%), and dilated cardiomyopathy (49; 18%). A total of 43 patients (16%) died during follow-up (mean 0.9 +/- 0.3 years, total 2,785 patient-months): 30 from cardiac causes, 9 from non-cardiac causes, and 4 from unknown causes. Actuarial transplant-free survival was 87% at 6 months, and 81% at 1 year. Renal disease, previous stroke, ischemic etiology, and poor left ventricular ejection fraction were independent predictors of mortality. CONCLUSIONS: Rheumatic disease is still the main cause of severe MR in Spain. Patients with severe MR have advanced age and present poor short-term prognosis.
Assuntos
Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/fisiopatologia , Idoso , Análise de Variância , Distribuição de Qui-Quadrado , Ecocardiografia , Feminino , Humanos , Masculino , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Sistema de Registros , Espanha , Taxa de SobrevidaRESUMO
Our aim was to investigate the prevalence of the different causes of severe mitral regurgitation and the influence of gender on that prevalence. We performed a prospective study of 272 consecutive patients with severe mitral regurgitation that had been detected echocardiographically. Their mean age was 70.2 (13.8) years, and 143 were women (52.6%). Atrial fibrillation was present in 52.9%, 72.7% presented with heart failure, and 21.0% with previous myocardial infarction. The most common etiological factor was rheumatic disease (in 26.5%), with the etiology being unclear in 32 patients (11.8%). Rheumatic disease was more frequent in women, at 35.7%, than in men, at 16.3%, whereas other etiologies were less frequent in women (P< .001). In all age groups, a rheumatic etiology was more frequent in women. Rheumatic heart disease remains the main cause of severe mitral regurgitation observed in women referred to hospitals similar to ours.
Assuntos
Insuficiência da Valva Mitral/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cardiopatia Reumática/complicações , Fatores SexuaisRESUMO
Para valorar la frecuencia actual de las distintas causas de insuficiencia mitral severa y la influencia del sexo en la etiología, realizamos un registro prospectivo de 272 pacientes consecutivos con insuficiencia mitral severa en el ecocardiograma. La edad media fue de 70,2 ± 13,8, con 143 mujeres (52,6%). El 52,9% presentaba fibrilación auricular, el 72,7% insuficiencia cardiaca y el 21,0%, infarto de miocardio previo. La etiología más frecuente fue la reumática (26,5%) y en 32 pacientes (11,8%) no se encontró una clara etiología de la regurgitación mitral. La enfermedad reumática fue más frecuente en mujeres (35,7%) que en varones (16,3%), mientras que otras etiologías fueron menos frecuentes en las mujeres (p < 0,001). Para todos los grupos de edad, la etiología reumática era más frecuente en mujeres. La enfermedad reumática sigue siendo la causa principal de la insuficiencia mitral grave en las mujeres remitidas a un hospital de las características del nuestro
Our aim was to investigate the prevalence of the different causes of severe mitral regurgitation and the influence of gender on that prevalence. We performed a prospective study of 272 consecutive patients with severe mitral regurgitation that had been detected echocardiographically. Their mean age was 70.2 (13.8) years, and 143 were women (52.6%). Atrial fibrillation was present in 52.9%, 72.7% presented with heart failure, and 21.0% with previous myocardial infarction. The most common etiological factor was rheumatic disease (in 26.5%), with the etiology being unclear in 32 patients (11.8%). Rheumatic disease was more frequent in women, at 35.7%, than in men, at 16.3%, whereas other etiologies were less frequent in women (P<.001). In all age groups, a rheumatic etiology was more frequent in women. Rheumatic heart disease remains the main cause of severe mitral regurgitation observed in women referred to hospitals similar to ours
