Outcome and undertreatment of mitral regurgitation: a community cohort study

Publication date: 10–16 March 2018 Source:The Lancet, Volume 391, Issue 10124 Author(s): Volha Dziadzko, Marie-Annick Clavel, Mikhail Dziadzko, Jose R Medina-Inojosa, Hector Michelena, Joseph Maalouf, Vuyisile Nkomo, Prabin Thapa, Maurice Enriquez-Sarano Background Mitral regurgitation is the most common valve disease worldwide but whether the community-wide prevalence, poor patient outcomes, and low rates of surgical treatment justify costly development of new therapeutic interventions remains uncertain. Therefore, we did an observational cohort study to assess the clinical characteristics, outcomes, and degree of undertreatment of mitral regurgitation in a community setting. Methods We used data from Mayo Clinic electronic health records and the Rochester Epidemiology Project to identify all cases of moderate or severe isolated single-valvular mitral regurgitation (with no other severe left-sided valvular disease or previous mitral surgery) diagnosed during a 10-year period in the community setting in Olmsted County (MN, USA). We assessed clinical characteristics, mortality, heart failure incidence, and results of cardiac surgery post-diagnosis. Findings Between Jan 1, 2000, and Dec 31, 2010, 1294 community residents (median age at diagnosis 77 years [IQR 66–84]) were diagnosed with moderate or severe mitral regurgitation by Doppler echocardiography (prevalence 0·46% [95% CI 0·42–0·49] overall; 0·59% [0·54–0·64] in adults). Left-ventricular ejecti...
Source: The Lancet - Category: General Medicine Source Type: research