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Course of chronic heart failure and prognosis in elderly patients in presence of functional mitral regurgitation

Larina V. N., Bart B. Ya., Dergunova E. N., Zakharenko G. D.

Keywords: mitral regurgitation, elderly age, prognosis, CHF

DOI: 10.18087 / rhfj.2013.3.1791

Background. Identification of RF for fatal outcome in patients with CHF presently remains an up-to-date challenge. Aim. To evaluate the CHF course and prognosis in elderly patients with functional mitral regurgitation (MR) during drug treatment. Materials and methods. Based on the MR degree, patients with NYHA FC II–IV CHF were divided into two groups. The first group included 81 patients aged 71 (65-76) years with degree 3–4 MR; the second group included 167 patients aged 68 (66-73) years with degree 1–2 MR. Patients were gender-, age-, and CHF duration matched. Results. One-way analysis showed that the presence of MI in history (р=0.016; OR, 2.6; 95 % CI, 1.19–5.68), LV aneurism (р=0.020; OR, 2.04; 95 % CI, 1.12–3.71), high CHF FC (p<0.001; OR, 3.24; 95 % CI, 2.02–5.20), enlarged left atrium (р<0.001; OR, 11.84; 95 % CI, 5.01–27.98), end-diastolic dimension (EDD) (р<0.001; OR, 4.59; 95 % CI, 2.88–7.31), and low LV EF (р<0.001, OR, 6.88; 95 % CI, 3.70–12.71) were independently associated with pronounced MR. Despite administration of current drug therapy, a probability of fatal outcome was higher in elderly patients with degree 3–4 MR than with degree 1–2 MR (OR, 2.18; 95 % CI, 1.2–3.9). LV EF <35 % (р=0.023; OR, 2.49; 95 % CI, 1.14–5.45), heart rate >70 bpm (р=0.027; OR, 1.02; 95 % CI, 1.00–1.04), LV EDD (р=0.005; OR, 1.6; 95 % CI, 1.15–2.26) were independent predictors of fatal outcome in CHF patients with pronounced MR. Conclusion. Degree 3–4 MR was found in 16.5 % of elderly patients. Prognosis for patients with degree 3–4 MR was worse than for patients of the same age but with a lower (degrees 1 and 2) MR degree.
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Larina V. N., Bart B. Ya., Dergunova E. N. et al. Course of chronic heart failure and prognosis in elderly patients in presence of functional mitral regurgitation. Russian Heart Failure Journal. 2013;14 (3):117-123

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