2008 Volume 6 Issue 1 Pages 15-20
Background. The influence of functional MR over the long-term prognosis in decompensated CHF is unclear. We investigated whether the dynamic changes in degree of mitral regurgitation (MR) and mitral valve tenting during intensive therapy using two-dimensional echocardiography influence long-term prognosis in decompensated congestive heart failure (CHF).
Methods. Forty patients who were admitted to our hospital for exacerbation of CHF were studied. Two-dimensional echocardiographic examinations were performed on admission and at discharge. Thirty eight patients who showed MR on admission were divided into two groups: MR responder, 31 patients with MR reduction during therapy; MR non-responder, 7 patients without MR reduction during therapy. The forty patients were also divided into two groups according to the tenting area: Tenting responder, 21 patients with tenting area reduction during therapy; Tenting non-responder, 19 patients without tenting area reduction during therapy. The long-term event rates of CHF and mortality rates were evaluated and compared by Kaplan-Meier method. Average follow-up period was 803±461days.
Results. Incidence of recurrent CHF was significantly lower in MR responder than MR non-responder (15/31 vs. 6/7, p=0.017) and also significantly lower in Tenting responder than Tenting non-responder (8/21 vs. 15/19, p=0.005). Mortality rate was significantly lower in Tenting responder than Tenting non-responder (6/21 vs. 15/19, p=0.004).
Conclusions. Reduction of mitral valve tenting area during intensive therapy predicted a good long-term prognosis of decompensated CHF.