Prognostic impact of moderate mitral regurgitation on hospitalized heart failure patients with preserved ejection fraction: A report from the JASPER registry
Prognostic impact of moderate mitral regurgitation on hospitalized heart failure patients with preserved ejection fraction: A report from the JASPER registry
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中度二尖瓣反流对射血分数保留的住院心力衰竭患者的预后影响：来自 JASPER 登记处的报告
DOI：
10.1007/s00380-020-01581-5
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发表时间：
2020
影响因子：
1.5
通讯作者：
Anzai Toshihisa
中科院分区：
文献类型：
--
作者：
Oikawa Masayoshi;Yoshihisa Akiomi;Sato Yu;Nagai Toshiyuki;Yoshikawa Tsutomu;Saito Yoshihiko;Yamamoto Kazuhiro;Takeishi Yasuchika;Anzai Toshihisa
越来越多的证据表明，二尖瓣返流（MR）与射血分数降低的心力衰竭患者的死亡率较高相关。然而，MR对射血分数保留的心力衰竭患者（HFpEF）的预后影响尚未得到充分研究。日本射血分数保留性心力衰竭综合征（碧玉）登记研究是一项针对LVEF ≥ 50%的连续日本住院HFpEF患者的全国性、观察性、前瞻性登记研究。该队列排除了严重的心脏瓣膜病。我们根据出院时二尖瓣返流的严重程度将连续341例患者分为两组：无或轻度二尖瓣返流组（n= 317）和中度二尖瓣返流组（n= 24）。与无或轻度二尖瓣返流组相比，中度二尖瓣返流组左室舒张末期内径增大（52 [48-59] vs. 46 [42-50] mm，P< 0.001），左心室收缩期内径（35 [30-37] vs. 29 [26-34] mm，P= 0.006），左心房直径（49 [46-56] vs. 45 [40-50] mm，P< 0.001）和更高的三尖瓣反流峰值梯度（33 [25-40] vs. 27 [21-33] mmHg，P= 0.012）。相比之下，血浆B型利钠肽水平和左心室射血分数在两组之间相当。在随访期间（中位数738天），有57例全因死亡。Kaplan-Meier分析显示，中度二尖瓣返流组的全因死亡率高于无二尖瓣返流组或轻度二尖瓣返流组（log-rankP= 0.023）。在考克斯比例风险分析中，出院时中度二尖瓣返流是全因死亡率的预测因子（风险比2.256，95%可信区间1.035- 4.917，P = 0.041）。出院时中度MR与HFpEF住院患者的不良预后相关。
A growing body of evidence suggests that mitral regurgitation (MR) is associated with higher mortality in heart failure patients with reduced ejection fraction. However, prognostic impact of MR on heart failure patients with preserved ejection fraction (HFpEF) has not been fully examined. The Japanese Heart Failure Syndrome with Preserved Ejection Fraction (JASPER) registry is a nationwide, observational, prospective registration of consecutive Japanese hospitalized HFpEF patients with LVEF ≥ 50%. Severe valvular heart disease was excluded from this cohort. We divided the consecutive 341 patients into two groups based on the severity of MR at discharge: no or mild MR group (n= 317) and moderate MR group (n= 24). Compared with no or mild MR group, moderate MR group showed larger left ventricular end-diastolic diameter (52 [48–59] vs. 46 [42–50] mm,P< 0.001), left ventricular systolic diameter (35 [30–37] vs. 29 [26–34] mm,P= 0.006), left atrial diameter (49 [46–56] vs. 45 [40–50] mm,P< 0.001), and higher tricuspid regurgitation peak gradient (33 [25–40] vs. 27 [21–33] mmHg,P= 0.012). In contrast, levels of plasma B-type natriuretic peptide and left ventricular ejection fraction were comparable between the two groups. In the follow-up period (median 738 days), there were 57 all-cause deaths. In the Kaplan–Meier analysis, all-cause mortality was higher in moderate MR group than in no or mild MR group (log-rankP= 0.023). In the Cox proportional hazard analysis, moderate MR at discharge was a predictor of all-cause mortality (hazard ratio 2.256, 95% confidence interval 1.035–4.917,P= 0.041). Moderate MR at discharge is associated with adverse prognosis in hospitalized patients with HFpEF.
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影响因子：
6.2
作者：
Gorter, Thomas M.;van Veldhuisen, Dirk J.;Hoendermis, Elke S.
通讯作者：
Hoendermis, Elke S.
房颤患者心房功能性二尖瓣反流的形态机制
DOI：
--
发表时间：
2019
期刊：
影响因子：
--
作者：
Kazuhiro Nagaoka;Yasushi Mukai;Shunsuke Kawai;Susumu Takase;Kazuo Sakamoto;Shujiro Inoue;Daisuke Yakabe;Shota Ikeda;Akiko Chishaki;Hiroyuki Tsutsu
通讯作者：
Hiroyuki Tsutsu
影响因子：
18.2
作者：
Kajimoto, Katsuya;Sato, Naoki;Takano, Teruo
通讯作者：
Takano, Teruo
影响因子：
6
作者：
Ennezat, Pierre Vladimir;Marechaux, Sylvestre;Le Jemtel, Thierry H.
通讯作者：
Le Jemtel, Thierry H.
影响因子：
158.5
作者：
Stone, G. W.;Lindenfeld, J. A.;Mack, M. J.
通讯作者：
Mack, M. J.