Mitral Regurgitation and Mortality Risk in Medicare Beneficiaries With Heart Failure and Preserved Ejection Fraction

The association of mitral regurgitation (MR) severity and mortality in heart failure with preserved ejection fraction (HFpEF) is uncertain. We sought to evaluate the relation between MR severity on transthoracic echocardiography (TTE) and subsequent all-cause mortality in Medicare beneficiaries with...

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Bibliographic Details
Published in:The American journal of cardiology 2022-11, Vol.183, p.40-47
Main Authors: Jiang, Ginger Y, Xu, Jiaman, Manning, Warren J, Markson, Lawrence J, Khabbaz, Kamal R, Garan, A Reshad, Sabe, Marwa A, Strom, Jordan B
Format: Article
Language:English
Subjects:
Aged
Algorithms
Aortic stenosis
Atrial Fibrillation - complications
Atrial Fibrillation - epidemiology
Beneficiaries
Body mass index
Cardiac arrhythmia
Chronic illnesses
Congestive heart failure
Data warehouses
Datasets
Echocardiography
Ejection fraction
Endocarditis
Evaluation
Female
Fibrillation
Government programs
Health care facilities
Heart Failure
Hospitalization
Humans
Male
Medical prognosis
Medicare
Mitral Valve Insufficiency
Mortality
Older people
Prognosis
Pulmonary arteries
Regurgitation
Retrospective Studies
Risk
Software
Stroke Volume
United States - epidemiology
Velocity
Ventricle
Ventricular Function, Left
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Summary:The association of mitral regurgitation (MR) severity and mortality in heart failure with preserved ejection fraction (HFpEF) is uncertain. We sought to evaluate the relation between MR severity on transthoracic echocardiography (TTE) and subsequent all-cause mortality in Medicare beneficiaries with HFpEF. We linked 57,608 patients referred for TTE at Beth Israel Deaconess Medical Center to Medicare inpatient claims from 2003 to 2017. In those with a history of HF and a physician-reported left ventricular ejection fraction ≥50%, we evaluated the relation of MR severity and time to the primary end point of all-cause mortality using Kaplan-Meier methods. A total of 7,778 individuals (14.5%) met inclusion criteria (mean age 75.5 years ± 11.9, 55.9% female). Over a median follow-up of 8.1 years, 2,016 (25.9%) died at a median (interquartile range) of 1.7 (0.3 to 4.1) years. At 1 year, 15.8% with 3 to 4+ MR had died versus 10.5% with 0 to 2+ MR (hazard ratio 1.54, 95% confidence interval 1.22 to 1.95, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2022.07.025