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首页> 外文期刊>The American Journal of Cardiology >Early Improvement of Functional Mitral Regurgitation in Patients With Idiopathic Dilated Cardiomyopathy
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Early Improvement of Functional Mitral Regurgitation in Patients With Idiopathic Dilated Cardiomyopathy

机译：特发性扩张型心肌病患者的功能性二尖瓣反流的早期改善

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The aim of the study was to assess the clinical and prognostic impact of early functional mitral regurgitation (FMR) improvement on the outcome of patients with idiopathic dilated cardiomyopathy (IDC). The prevalence and prognostic role of FMR improvement, particularly at early follow-up, in patients with IDC are still unclear. From 1988 to 2009, we enrolled 470 patients with IDC with available FMR data at baseline and after 6 +/- 2 months. According to the evolution of FMR, patients were classified into 3 groups: stable absent-mild FMR, early FMR improvement (downgrading from moderate-severe to absent-mild), and persistence/early development of moderate-severe FMR. At baseline, 177 of 470 patients (38%) had moderate-severe FMR. Patients with early FMR improvement had significantly better survival rate free from heart transplant with respect to those with persistence/early development of moderate-severe FMR (93%, 81%, and 66% vs 91%, 64%, and 52% at 1, 6, and 12 years, respectively; p = 0.044). At 6-month follow-up multivariate analysis, FMR improvement was associated with better prognosis (hazard ratio 0.78, 95% confidence interval [CI] 0.64 to 0.96, p = 0.02); the other independent predictors were male gender, heart failure duration, and early re-evaluation of the New York Heart Association class and left ventricle systolic function. This model provided more accurate risk stratification compared with the baseline model (Net Reclassification Index 80% at 12 months and 41% at 72 months). In conclusion, in a large cohort of patients with]DC receiving optimal medical treatment, early improvement of FMR was frequent (53%) and emerged as a favorable independent prognostic factor with an incremental short- and long-term power compared with the baseline evaluation. (C) 2015 Elsevier Inc. All rights reserved.
机译：该研究的目的是评估早期功能性二尖瓣关闭不全（FMR）改善对特发性扩张型心肌病（IDC）患者的预后的临床和预后影响。 FMR改善的发生率和预后作用，特别是在早期随访中，在IDC患者中仍然不清楚。从1988年到2009年，我们招募了470名IDC患者，这些患者在基线时以及6 +/- 2个月后均具有可用的FMR数据。根据FMR的发展，将患者分为3组：稳定的无轻度FMR，早期的FMR改善（从中度至重度降级至无轻度）以及持续性/早期发展为中度FMR。在基线时，470名患者中有177名（38％）患有中度重度FMR。早期FMR改善的患者相对于持续/早期发展为中度严重FMR的患者，无心脏移植的存活率显着更高（93％，81％和66％，而91％，64％和52％为1） ，6年和12年; p = 0.044）。在6个月的随访多变量分析中，FMR改善与预后更好相关（危险比0.78，95％置信区间[CI]为0.64至0.96，p = 0.02）;其他独立的预测指标是男性，心衰持续时间，纽约心脏协会分类和左心室收缩功能的早期重新评估。与基线模型相比，该模型提供了更准确的风险分层（净重分类指数在12个月时为80％，在72个月时为41％）。总之，在接受最佳药物治疗的大量DC患者中，FMR的早期改善率很高（53％），并且与基线评估相比，已成为一种有利的独立预后因素，其短期和长期疗效均得到提高。 （C）2015 Elsevier Inc.保留所有权利。

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