Prognostic study on atrial and ventricular functional mitral regurgitation
Objective To investigate the prognosis of patients with different types of functional mitral regurgitation(FMR).Methods The study included patients with grade 3+and grade 4+FMR who were admitted to our hospital for the first time between January 2020 to January 2022.The median follow-up period was 30 months.Based on the patients'medical history and echocardiography characteristics,they were categorized into the ventricular FMR(VFMR)group and the atrial FMR(AFMR)group.Medical records and prognosis data were collected and then analyzed to determine the all-cause mortality rate and heart failure readmission rate of patients with different types of FMR and their influencing factors.Results A total of 357 patients were included in the study,with a mean age of 65 years.There were 230 males and 127 females.Among them,there were 273 cases in the VFMR group and 84 cases in the AFMR group.The main endpoints of the study were all-cause mor-tality,heart failure readmission rate,and the composite endpoint occurrence rate of both.The composite endpoint occurence rate in the AFMR group were significantly lower than those in the VFMR group[HR=0.51,95％CI(0.33,0.79),P＜0.05].The occurrence rate of the composite endpoint in FMR patients with atrial fibrillation was higher than that in those with-out atrial fibrillation(VFMR group P＜0.01,AFMR group P=0.01).There was no significant difference in the occurrence rate of the composite endpoint between ischemic and non-ischemic VFMR(P=0.24).Cox regression analysis was used to ana-lyze the main influencing factors of composite endpoints.The prognostic factors for VFMR and AFMR were different.High lev-els of B-type natriuretic peptide(BNP)were an independent risk factor for cardiovascular events in VFMR,while creatinine and left ventricular end-diastolic diameter were independent risk factors for cardiovascular events in AFMR.Conclusion The prog-nosis of AFMR is significantly better than that of VFMR,and the prognostic factors differ between the two.
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