Τίτλος:
Impact of mitral regurgitation in patients with acute heart failure: insights from the RELAX-AHF-2 trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aims: The impact of mitral regurgitation (MR) in patients hospitalized for acute heart failure (AHF) is not well established. We assessed the role of MR in patients enrolled in the Relaxin in Acute Heart Failure 2 (RELAX-AHF-2) trial. Methods and results: Patients enrolled in RELAX-AHF-2 with available data regarding MR status were included in this analysis. Baseline characteristics, in-hospital data, and clinical outcomes through 180-day follow-up were evaluated. The impact of moderate/severe MR was assessed. Among 6420 AHF patients with known MR status, 1810 patients (28.2%) had moderate/severe MR. Compared to patients with no/mild MR, those with moderate/severe MR were more likely to have history of heart failure (HF), prior HF hospitalization, more comorbidities, symptoms/signs of HF, lower left ventricular ejection fraction and higher N-terminal pro-B-type natriuretic peptide levels. Moderate/severe MR was associated with longer length of hospital stay, higher rates of residual dyspnoea, increased jugular venous pressure through the index hospitalization and a higher unadjusted risk of the composite of cardiovascular (CV) death or rehospitalization for HF/renal failure (RF) through 180 days (crude hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.03–1.27, p = 0.01). The association between moderate/severe MR and poorer outcomes was not maintained in a multivariable model including several covariates of interest (adjusted HR 1.03, 95% CI 0.91–1.17, p = 0.65). Similar findings were observed for HF/RF rehospitalization alone. Conclusions: In patients with AHF, moderate/severe MR was associated with a worse clinical profile but did not have an independent prognostic impact on clinical outcomes. © 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
Συγγραφείς:
Pagnesi, M.
Adamo, M.
ter Maaten, J.M.
Beldhuis, I.E.
Cotter, G.
Davison, B.A.
Felker, G.M.
Filippatos, G.
Greenberg, B.H.
Pang, P.S.
Ponikowski, P.
Sama, I.E.
Severin, T.
Gimpelewicz, C.
Voors, A.A.
Teerlink, J.R.
Metra, M.
Περιοδικό:
European Journal of Heart Failure
Εκδότης:
John Wiley and Sons Ltd
Λέξεις-κλειδιά:
amino terminal pro brain natriuretic peptide; creatinine; loop diuretic agent; urea, acute heart failure; adult; analytical parameters; Article; body weight loss; breathing disorder; breathing rate; cardiovascular mortality; central venous pressure; comorbidity; controlled study; crackle; creatinine blood level; disease severity; double blind procedure; dyspnea; estimated glomerular filtration rate; exertional dyspnea; female; follow up; heart failure; heart left ventricle ejection fraction; heart rate; hospital readmission; hospitalization; human; length of stay; major clinical study; male; mitral valve regurgitation; multicenter study; orthopnoea; peripheral edema; phase 3 clinical trial; physical disease by body function; protein blood level; randomized controlled trial; systolic blood pressure; treatment response; urea creatinine ratio; urea nitrogen blood level; acute disease; complication; heart failure; heart left ventricle function; heart stroke volume, Acute Disease; Heart Failure; Hospitalization; Humans; Mitral Valve Insufficiency; Stroke Volume; Ventricular Function, Left
