Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Regurgitant volume to left ventricular end-diastolic volume ratio: the quest to identify Disproportionate MR is not over
Session:
CO 06 - Valvulopatias
Speaker:
Francisco Albuquerque
Congress:
CPC 2021
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Francisco Albuquerque; Pedro m. Lopes; Pedro Freitas; Eduarda Horta; Carla Reis; António m. Ferreira; João Abecassis; Marisa Trabulo; Manuel Canada; Regina Ribeiras; Miguel Mendes; Maria João Andrade
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Background: </span></strong><span style="font-family:"Times New Roman",serif"> Quantification of secondary mitral valve regurgitation (SMR) remains challenging. Proportionate and Disproportionate SMR provides a conceptual framework that relates the degree of SMR to left ventricular dilatation and dysfunction. In line with this concept, regurgitant volume to LV end-diastolic volume ratio (Rvol/LVEDV) was recently proposed as a possible strategy to identify patients with Disproportionate SMR. The aim of this study was to validate this approach in a Portuguese cohort. </span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Methods: </span></strong><span style="font-family:"Times New Roman",serif">In a single center cohort of patients with heart failure and reduced left ventricular ejection fraction (HFrEF <50%) under optimal guideline-directed medical therapy (GDMT), we retrospectively identified those with at least moderate SMR. According to the published literature, we divided the study population into 2 risk groups: those with a Rvol/LVEDV ratio </span><span style="font-family:Symbol">³</span><span style="font-family:"Times New Roman",serif"> 20% (greater MR/ smaller LVEDV) and those with a ratio < 20% (smaller MR/ larger EDV). Cox regression and Kaplan-Meier survival analysis were used to assess the association between Rvol/LVEDV ratio and all-cause mortality.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Results: </span></strong><span style="font-family:"Times New Roman",serif">A total of 154 patients (mean age 69 ± 12 years; 81% male) were included. Mean LVEF was 31 ± 8% and median LVEDV was 193 mL (IQR: 155 to 236 mL). There were 74 patients (48.1%) with a Rvol/LVEDV ratio < 20% and 80 patients (51.9%) Rvol/LVEDV ratio </span><span style="font-family:Symbol">³</span><span style="font-family:"Times New Roman",serif"> 20%. Regarding GDMT, 141 (91.6%) received beta-blockers, 139 (90.3%) angiotensin converting–enzyme inhibitors/angiotensin receptor blockers and 77 (50.0%) were under mineralocorticoid therapy. Also, there were patients 49 (31.8%) under cardiac resynchronization therapy and 40 patients (26.0%) had an implantable cardioverter defibrillator. During a median follow-up of 2.1 years (IQR 0.7 to 3.8 years), 92 (59.7%) patients died. Cox regression and survival analysis showed no mortality difference between patients with a Rvol/LVEDV ratio < 20% and those with a ratio </span><span style="font-family:Symbol">³</span><span style="font-family:"Times New Roman",serif"> 20% (HR: 1.04; 95% CI 0.69 – 1.57; <em>P</em> = 0.854; Log-rank <em>P</em> = 0.967) – see also figure. </span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Conclusion: </span></strong><span style="font-family:"Times New Roman",serif">In a Portuguese cohort of HFrEF patients under optimized GDMT and with at least moderate SMR, the Rvol/LVEDV ratio was not associated with an increased risk of all-cause mortality. As such, the Rvol/LVEDV ratio does not seem to be a reliable surrogate of Disproportionate SMR, possibly because it does not account for the degree of LV dysfunction. </span></span></span></p>
Our mission: To reduce the burden of cardiovascular disease
Visit our site