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Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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01. History of Cardiology
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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Abstract
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CLEAR FILTERS
Predictors of mortality in mitral valve prolapse
Session:
Painel 9 -Doença Valvular 3
Speaker:
Pedro Silvério António
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.2 Valvular Heart Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Pedro Silvério António; Joana Rigueira; Tiago Graça Rodrigues; Inês Aguiar Ricardo; Rafael Santos; Afonso Nunes Ferreira; Nelson P. Cunha; Sara Couto Pereira; Pedro Morais; Joana Brito; Rui Plácido; Cláudio David; Susana Gonçalves; Fausto José Pinto; Ana G. Almeida
Abstract
<p>Introduction: Mitral valve prolapse (MVP) is a prevalent valvular pathology, commonly associated with a benign prognosis. Previous series have reported an excessive risk of mortality, however definite predictors of mortality remain to be established.</p> <p>Objective: We aimed to evaluate predictors of mortality in a population with MVP.</p> <p>Methods: A single-center retrospective study of consecutive patients with MVP documented in transthoracic echocardiogram between January 2014 and October 2019. MVP was defined as systolic displacement of the mitral leaflet into the left atrium≥ 2 mm from the mitral annular plane. Demographic, clinical, echocardiographic, electrocardiographic data were collected and adverse events, including mortality, were also analyzed during follow-up. The results were obtained using Chi-square and Student-t tests; logistic regression was used to find predictors of death.</p> <p>Results: 247 patients were included (mean age 62.9 ± 18 years, 61% males), most with MVP involving the posterior leaflet (48.6%). 40% of the patients had symptoms, 47.4% had significant mitral regurgitation (>moderate), 18.6% had aortic dilatation and 25% had interventricular conduction delay in the ECG. During a mean follow-up of 30 ± 19 months, 38% had arrythmias, 27.1% needed mitral valve intervention (95% surgery and 5% percutaneous), 27.1% had atrial fibrillation, 0.8% had acute aortic syndrome, 13.3% had hospital admission for cardiovascular cause and 8.5% (n=21) died. 9.3% (n=23) of the patients had mitral annulus disjunction, but this was not associated with more death in our population. <br /> Acute aortic syndrome was associated with death (p=0.019), as hospital admission (p=0.003), LBBB (p=0.001) and higher NYHA functional class (p=0.006). Sinus rhythm (OR 0.3 CI95% 0.119-0.786, p=0.014) and prolapse (OR 0.37 CI95%0.148-0.935, p=0.035) according to the ESC classification (comparing to flail and billowing) predicted survival.<br /> In multivariate analysis hospitalization for cardiovascular cause (p=0.011 OR 7.27 CI 95% 1-59-33.3), higher NYHA functional class (III-IV) (p=0.036 OR 5.7 CI95% 1.125-28.84) and the presence of LBBB (p=0.021 OR=6.78 CI95% 1.13-28.85) were independent predictors of mortality.<br /> Mitral regurgitation severity and intervention were not associated with death in this population.</p> <p>Conclusion: Although commonly described as a benign entity, in our population MVP had a mortality rate of 8.5%, being hospitalization, severely symptomatic heart failure and LBBB predictors of death. More studies are needed to establish the definite markers of death in patients with MVP.</p>
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