Impact Of Functional Mitral Regurgitation On Short-term Prognosis In Patients With Acute Decompensated Heart Failure And Reduced Ejection Fraction

Objective To evaluate the impact of functional mitral regurgitation(FMR)on short-term adverse outcomes in patients hospitalized with acute decompensated heart failure(HF)and reduced ejection fraction(HFrEF).Methods The patients hospitalized with acute decompensated HFrEF in Anhui Provincial Hospital From March 2015 to October 2018 were included and divided into none or mild group,moderate group and severe group according to the severity of FMR.The clinical characteristics and the occurrence of primary composite endpoints(including all-cause death and/or rehospitalization due to HF)at 90 d follow-up after enrollment among the three groups were compared.Results A total of 784 patients was enrolled in final analysis.According to the severity of FMR,338 patients were in none or mild group(43.1%),416 in moderate group(53.1%),and other 30 in severe group(3.8%).Compared to patients with none or mild FMR(12.4%),the occurrence of primary composite endpoints were significantly higher for patients with moderate(20.9%)and severe(30.0%)FMR(P=0.002)at 90 d follow-up.Kaplan-Meier survival analysis showed a statistically significant difference in survival free from re-hospitalization due to HF among the three groups of patients(P=0.001).Multivariate Cox regression analysis showed that moderate FMR and severe FMR were both independent risk factors of primary composite endpoints at 90 d follow-up with the hazard ratio(HR)and 95% confidence interval(CI)of 1.779(1.225-2.584,P=0.002)and 2.330(1.123-4.835,P=0.023).Conclusion In patients with acute decompensated HFrEF,the proportion of moderate and severe FMR is high which is associated with poor short-term prognosis.