Functional mitral regurgitation predicts 1-year mortality in elderly patients with systolic chronic heart failure

Eur J Heart Fail. 2005 Dec;7(7):1112-7. doi: 10.1016/j.ejheart.2005.01.016.


Background and aim: Mitral regurgitation (MR) has been demonstrated to be a powerful predictor of adverse outcome in middle-aged patients with chronic heart failure (CHF). In this study, we sought to define the prognostic impact of functional mitral regurgitation in a population of elderly patients with systolic CHF.

Methods: One hundred seventy-five outpatients aged >70 years with validated CHF and left ventricular ejection fraction <40% underwent clinical and echocardiographic evaluations at baseline. Mitral regurgitation was diagnosed by Color Doppler and quantified in 5 categorical values using a 0-4+ grading system. Outcome measures included 1-year mortality and hospitalization for worsening CHF.

Results: The distribution of patients according to the 5 different degrees of MR detected at baseline was: absent=11%, 1+=31%, 2+=38%, 3+=16%, 4+=4%. The relationship between MR and mortality was direct and approximately linear (r=0.39, p=0.00001). The prevalence of death in the 5 subgroups was 0%, 7%, 15%, 45%, 57%, respectively. Multivariate logistic regression analysis showed that MR was the strongest predictor of death (OR 4.47, 95% CI 1.50-13.0), independently of the presence of diabetes mellitus, older age and larger left ventricular end-diastolic volume. No association was found between MR and hospitalization for worsening CHF (r=0.08, p=0.41).

Conclusions: This study establishes the direct and independent relationship between MR severity and one-year mortality among elders with systolic CHF. Conversely, MR does not provide useful information regarding the risk of subsequent hospitalization for worsening CHF.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Disease Progression
  • Echocardiography, Doppler, Color
  • Female
  • Follow-Up Studies
  • Heart Failure / complications
  • Heart Failure / mortality*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Mitral Valve Insufficiency / complications*
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / physiopathology
  • Prognosis
  • Retrospective Studies
  • Stroke Volume / physiology
  • Survival Rate