Three-Dimensional Echocardiography-Derived Vena Contracta Area at Rest and Its Increase During Exercise Predicts Clinical Outcome in Mild-Moderate Functional Mitral Regurgitation
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- Vecera Jan
- Cardiovascular Center Aalst, OLV Clinic
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- Bartunek Jozef
- Cardiovascular Center Aalst, OLV Clinic
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- Vanderheyden Marc
- Cardiovascular Center Aalst, OLV Clinic
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- Kotrc Martin
- Institute of Clinical and Experimental Medicine (IKEM)
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- Kockova Radka
- Institute of Clinical and Experimental Medicine (IKEM)
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- Penicka Martin
- Cardiovascular Center Aalst, OLV Clinic
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Background:This study assessed the independent significance of color Doppler 3-D vena contracta area (VCA) at rest and during exercise as a predictor of clinical outcome in mild-moderate functional mitral regurgitation (FMR).Methods and Results:The subjects consisted of 62 patients (age, 68±11 years; 76% male) with chronic systolic heart failure and mild-moderate FMR (<2+/4) at rest. All patients underwent VCA assessment at rest and during semi-supine bicycle exercise. During median follow-up of 17 months (IQR, 13–20 months), 15 patients (24%) had composite endpoint of all-cause death (n=3), heart failure admission (n=11), and heart transplantation (n=1). At baseline, patients with vs. without endpoint had significantly larger VCA at rest (17±6 mm2vs. 13±7 mm2, P=0.002) and at peak exercise (35±16 mm2vs. 21±12 mm2, P<0.001). On Cox regression analysis, large (≥15-mm2) resting VCA (HR, 7.6; 95% CI: 1.93–13.02; P=0.004) and large (≥20-mm2) exercise-induced increase of VCA (HR, 5.1; 95% CI: 1.39–15.21; P=0.014) were independently associated with composite endpoint. Concomitant presence of large VCA at rest and its large increase during exercise occurred in 53% of patients with, vs. in only 8% without, endpoint (negative predictive value, 86%).Conclusions:The presence of relatively large VCA at rest and its significant increase during exercise is independently associated with adverse clinical outcome in patients with mild-moderate FMR at rest. (Circ J 2014; 78: 2741–2749)
収録刊行物
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- Circulation Journal
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Circulation Journal 78 (11), 2741-2749, 2014
一般社団法人 日本循環器学会
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詳細情報
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- CRID
- 1390282680084358528
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- NII論文ID
- 130004693856
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- NII書誌ID
- AA11591968
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- COI
- 1:STN:280:DC%2BC2M7ntlOrsw%3D%3D
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 025863067
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- PubMed
- 25283687
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可