Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(8), 922–929. https://doi.org/10.1002/clc.24067 Dr. Jiangtao Li et al.
Points
- The study examined 112 patients with functional mitral regurgitation (FMR) and nonischemic dilated cardiomyopathy (DCM) to compare clinical outcomes between mitral valve repair (MVr) and medical treatment groups.
- Patients who underwent MVr had significantly better outcomes, with a lower occurrence of the primary composite outcome (44.8%) than the medical group (68.5%).
- The 1-, 3-, and 5-year survival rates were notably higher for MVr patients (96.6%, 91.8%, and 77.4%) than for the medical group (81.2%, 71.9%, and 65.1%).
- Independent predictors associated with adverse outcomes included LVEF below 41.5% and atrial fibrillation for the primary outcome, LVEF below 41.5%, and renal insufficiency. They left ventricular end-diastolic diameter above 66.5 mm for all-cause death.
- The study’s findings support the superiority of MVr over medical therapy for patients with FMR and nonischemic DCM and emphasize the importance of LVEF in predicting clinical outcomes.
Summary
A study involving 112 patients with moderate or severe functional mitral regurgitation (FMR) and nonischemic dilated cardiomyopathy (DCM) sought to investigate the clinical outcomes associated with different treatment strategies and the predictors of adverse outcomes. The primary objective was to compare the clinical outcomes, particularly the composite outcome of all-cause death or unplanned hospitalization for heart failure, while also examining secondary outcomes such as cardiovascular death.
The results revealed a notable disparity in outcomes between the treatment groups. The study found that the primary composite outcome occurred in 44.8% of patients in the mitral valve repair (MVr) group, in contrast to 68.5% of patients in the medical treatment group, signifying a significantly better prognosis for those who underwent MVr. The survival rates at 1, 3, and 5 years were substantially higher for MVr patients (96.6%, 91.8%, and 77.4%, respectively) compared to the medical group (81.2%, 71.9%, and 65.1%, respectively). Additionally, the study identified left ventricular ejection fraction (LVEF) below 41.5% and atrial fibrillation as independent predictors associated with the primary outcome. Furthermore, LVEF below 41.5%, renal insufficiency, and left ventricular end-diastolic diameter above 66.5 mm were independently associated with a heightened risk of all-cause death.
In conclusion, the research demonstrated that MVr treatment yielded more favorable outcomes for patients with moderate or severe FMR and nonischemic DCM than medical therapy. The study’s findings underscore the significance of LVEF below 41.5% as a critical, independent predictor for both primary and secondary clinical outcomes. These insights can inform clinical decision-making and contribute to more effective management strategies for this patient population.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24067
References Li, J., & Wei, X. (2023). Outcomes and predictors of patients with moderate or severe functional mitral regurgitation and nonischemic dilated cardiomyopathy. Clinical Cardiology, 46(8), 922–929. https://doi.org/10.1002/clc.24067
