José L. Zamorano1,10, Juan Manuel Monteagudo1, Dolores Mesa2, Teresa Gonzalez-Alujas3, Marta Sitges4, Fernando Carrasco-Chinchilla5, Chi-Hion Li6, Antonio Grande-Trillo7, Amparo Martinez8, Javier Matabuena7, David Alonso-Rodriguez9, Covadonga Fernandez-Golfin11University Alcala de Henares, Hospital Ramon y Cajal, Carretera de Colmenar Km 9.100, Madrid, Spain
2Cardiology Department, Hospital Reina Sofia, Cordoba, Spain
3Cardiology Department, Hospital General Universitari Vall d’Hebron, Barcelona, Spain
4Cardiology Department, Thorax Institute, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
5Cardiology Department, Hospital Virgen de la Victoria, Malaga, Spain
6Cardiology Division, Department of Medicine, Hospital de Sant Pau I de la Santa Creu, Universidad de Barcelona, Barcelona, Spain
7Cardiology Department, Hospital Virgen del Rocío, Sevilla, Spain
8Cardiology Department, Hospital Clinico Santiago de Compostela, A Coruña, Spain
9Cardiology Department, Hospital de León, León, Spain
10Electronic correspondence: firstname.lastname@example.org
Background and aim of the study: Although mitral regurgitation (MR) is a well-recognized prognosis factor, its true prevalence is probably underestimated and its etiology and mechanisms have not been sufficiently explored. The study aim was to evaluate the burden of MR, focusing attention on its frequency, severity, etiology, mechanism, and other associated conditions.
Methods: Between February and June 2015, a total of 39,855 consecutive echocardiographic studies was performed at nine tertiary hospitals, and were prospectively included in the study. MR severity was graded into four groups, ranging from none or trace to severe MR, in accordance with the recommendations of the European Association of Cardiovascular Imaging. Patients with moderate to severe MR were selected for the analysis.
Results: MR was detected in 22.6% of cases. MR severity was mild in 82.5% of patients (n = 7,376), moderate in
11.7% (n = 1,048), and severe in 5.8% (n = 521). Concomitant valvular heart disease was present in 3,544 patients (39.7%), with tricuspid regurgitation the most frequently encountered (21.6%). Among moderate and severe MR, primary MR was more frequent than secondary MR (58.8% versus 23.5%), with degenerative valve disease being the most common cause of primary MR (49.2%). A third group composed of mixed forms of MR was described in 17.8% of cases.
Conclusion: MR is a common finding on echocardiography, and is frequently associated with other valvular heart disease. Most MRs are of degenerative origin. The primary and secondary forms of MR differ significantly in their clinical presentation with regard to gender, age, and ventricular function. There appears to be a gap for a ‘mixed’ group, though further studies are needed to confirm this suggestion.
The Journal of Heart Valve Disease 2016;25:724-729
|Frequency, Mechanism and Severity of Mitral Regurgitation: Are There any Differences Between Primary and Secondary Mitral Regurgitation?|
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