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Abstract：
BACKGROUND: The epidemiological distribution of functional mitral regurgitation (FMR) in heart failure (HF) and mildly reduced ejection fraction (HFmrEF) patients and its impact on outcomes remains unclear. We attempt to investigate the prognosis of FMR in patients with HFmrEF.
METHODS: The HF center registry study is a prospective, single, observational study conducted at the Second Affiliated Hospital of Shenzhen University, where 2330 patients with acute HF (AHF) were enrolled and 890 HFmrEF patients were included in the analysis. The patients were stratified into three categories based on the severity of FMR: none/mild, moderate, and moderate-to-severe/severe groups. Subsequently, a comparison of the clinical characteristics among these groups was conducted, along with an assessment of the incidence of the primary endpoint (comprising all-cause mortality and readmission for HF) during a one-year follow-up period.
RESULTS: The one-year follow-up results indicated that the primary composite endpoint occurrence rates in the three groups were 23.5%, 32.9%, and 36.5%, respectively. The all-cause mortality rates in the three groups were 9.3%, 13.7%, and 16.4% respectively. Survival analysis demonstrated a statistically significant difference in the occurrence rates of the primary composite endpoint and all-cause mortality among the three groups (P < 0.05). Multifactor Cox regression revealed that moderate FMR and moderate-to-severe/severe FMR were independent risk factors for adverse clinical prognosis in HFmrEF patients, with hazard ratios and 95% confidence intervals of 1.382 (1.020-1.872, P = 0.037) and 1.546 (1.092-2.190, P = 0.014) respectively.
CONCLUSIONS: Moderate FMR and moderate-to-severe/severe FMR independently predict an unfavorable prognosis in patients with HFmrEF.
METHODS: The HF center registry study is a prospective, single, observational study conducted at the Second Affiliated Hospital of Shenzhen University, where 2330 patients with acute HF (AHF) were enrolled and 890 HFmrEF patients were included in the analysis. The patients were stratified into three categories based on the severity of FMR: none/mild, moderate, and moderate-to-severe/severe groups. Subsequently, a comparison of the clinical characteristics among these groups was conducted, along with an assessment of the incidence of the primary endpoint (comprising all-cause mortality and readmission for HF) during a one-year follow-up period.
RESULTS: The one-year follow-up results indicated that the primary composite endpoint occurrence rates in the three groups were 23.5%, 32.9%, and 36.5%, respectively. The all-cause mortality rates in the three groups were 9.3%, 13.7%, and 16.4% respectively. Survival analysis demonstrated a statistically significant difference in the occurrence rates of the primary composite endpoint and all-cause mortality among the three groups (P < 0.05). Multifactor Cox regression revealed that moderate FMR and moderate-to-severe/severe FMR were independent risk factors for adverse clinical prognosis in HFmrEF patients, with hazard ratios and 95% confidence intervals of 1.382 (1.020-1.872, P = 0.037) and 1.546 (1.092-2.190, P = 0.014) respectively.
CONCLUSIONS: Moderate FMR and moderate-to-severe/severe FMR independently predict an unfavorable prognosis in patients with HFmrEF.
摘要：
背景：心力衰竭（HF）和轻度射血分数降低（HFmrEF）患者中功能性二尖瓣反流（FMR）的流行病学分布及其对预后的影响尚不清楚。我们试图研究HFmrEF患者的FMR预后。
方法：HF中心注册研究是一项前瞻性的，单身,在深圳大学第二附属医院进行的观察研究，其中纳入了2330例急性HF（AHF）患者，并将890例HFmrEF患者纳入分析。根据FMR的严重程度将患者分为三类：无/轻度，中度,和中度至重度/重度组。随后，对这些组的临床特征进行了比较，以及在1年随访期间评估主要终点(包括全因死亡率和HF再入院率)的发生率.
结果：一年的随访结果表明，三组的主要复合终点发生率为23.5％，32.9%,和36.5%，分别。三组全因死亡率为9.3%,13.7%,和16.4%。生存分析显示，三组间主要复合终点发生率和全因死亡率差异有统计学意义（P<0.05）。多因素Cox回归分析显示，中度FMR和中重度/重度FMR是HFmrEF患者临床预后不良的独立危险因素。风险比和95％置信区间分别为1.382（1.020-1.872，P=0.037）和1.546（1.092-2.190，P=0.014）。
结论：中度FMR和中度至重度/重度FMR独立预测HFmrEF患者的不良预后。
方法：HF中心注册研究是一项前瞻性的，单身,在深圳大学第二附属医院进行的观察研究，其中纳入了2330例急性HF（AHF）患者，并将890例HFmrEF患者纳入分析。根据FMR的严重程度将患者分为三类：无/轻度，中度,和中度至重度/重度组。随后，对这些组的临床特征进行了比较，以及在1年随访期间评估主要终点(包括全因死亡率和HF再入院率)的发生率.
结果：一年的随访结果表明，三组的主要复合终点发生率为23.5％，32.9%,和36.5%，分别。三组全因死亡率为9.3%,13.7%,和16.4%。生存分析显示，三组间主要复合终点发生率和全因死亡率差异有统计学意义（P<0.05）。多因素Cox回归分析显示，中度FMR和中重度/重度FMR是HFmrEF患者临床预后不良的独立危险因素。风险比和95％置信区间分别为1.382（1.020-1.872，P=0.037）和1.546（1.092-2.190，P=0.014）。
结论：中度FMR和中度至重度/重度FMR独立预测HFmrEF患者的不良预后。
