@article{df0e68824d7642cabf0d03deabd4e6eb,
title = "Prevalence and Prognostic Significance of Mitral Regurgitation in Acute Decompensated Heart Failure: The ARIC Study",
abstract = "Objectives: This study investigates the prevalence and prognostic significance of mitral regurgitation (MR) in acute decompensated heart failure (ADHF) patients. Background: Few studies characterize the burden of MR in heart failure. Methods: The ARIC (Atherosclerosis Risk In Communities) study surveilled ADHF hospitalizations for residents ≥55 years of age in 4 U.S. communities. ADHF cases were stratified by left ventricular ejection fraction (LVEF): <50% and ≥50%. Odds of moderate or severe MR in patients with varying sex and race, and odds of 1-year mortality in those with higher MR severity were estimated using multivariable logistic regression. Results: From 2005 to 2014, there were 17,931 weighted ADHF hospitalizations of which 49.2% had an LVEF <50% and 50.8% an LVEF ≥50%. Moderate or severe MR prevalence was 44.5% in those with an LVEF <50% and 27.5% in those with an LVEF ≥50%. Moderate or severe MR was more likely in females than males regardless of LVEF; LVEF <50% (odds ratio [OR]: 1.21 [95% confidence interval (CI): 1.11 to 1.33]), LVEF ≥50% (OR: 1.52 [95% CI: 1.36 to 1.69]). Among hospitalizations with an LVEF ≥50%, moderate or severe MR was less likely in blacks than whites (OR: 0.72 [95% CI: 0.64 to 0.82]). Higher MR severity was independently associated with increased 1-year mortality in those with an LVEF <50% (OR: 1.30 [95% CI: 1.16 to 1.45]). Conclusions: Patients with ADHF have a significant MR burden that varies with sex and race. In ADHF patients with an LVEF <50%, higher MR severity is associated with excess 1-year mortality.",
keywords = "ADHF, Atherosclerosis Risk In Communities study, HF, MR, mortality",
author = "Sameer Arora and Krishan Sivaraj and Michael Hendrickson and Chang, {Patricia P.} and Thelsa Weickert and Arman Qamar and Muthiah Vaduganathan and Caughey, {Melissa C.} and Ambarish Pandey and Cavender, {Matthew A.} and Wayne Rosamond and Vavalle, {John P.}",
note = "Funding Information: The ARIC study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Department of Health and Human Services, under contract nos. HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, and HHSN268201700004I. Dr. Qamar is supported by Daiichi Sankyo, the NIH T32 Program, and the American Heart Association Strategically Focused Research Networks in Vascular Disease grant. Dr. Vaduganathan is supported by the KL2/Catalyst Medical Research Investigator Training award from Harvard Catalyst NIH/NCATS Award UL 1TR002541. Dr. Pandey has served as an advisory board member for Roche Diagnostics; and has also received research funding from the Texas Health Resources Clinical Scholarship, Gilead Sciences Research Scholar Program, and the National Institute of Aging GEMSSTAR Grant (1R03AG067960-01). Dr. Vavalle is supported by a research grant from CSI Inc. Dr. Qamar has been an AD hoc consultant/speaker for the American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Pfizer, Medscape, and the Clinical Exercise Physiology Association. Dr. Vaduganathan has served on advisory boards for Amgen, AstraZeneca, Baxter Healthcare, Bayer AG, Boehringer Ingelheim, Cytokinetics, and Relypsa; and has participated on clinical endpoint committees for studies sponsored by Novartis and the NIH. Dr. Pandey has served as an advisory board member for Roche Diagnostic Corporation. Dr. Cavender has received non-salary research support from Amgen, AstraZeneca, Chiesi, CSL Behring, GlaxoSmithKline, and Novartis; salary research support from Novo-Nordisk; and consulting fees from Amgen, AstraZeneca, Boehringer Ingelheim, Boston Scientific, Edwards Lifesciences, and Merck. Dr. Vavalle has been a principal investigator for Abbott Medical Device Company, Boston Scientific, and Cardiac Dimensions, Inc.; has received consulting fees from Edwards Lifesciences; and has an honorarium from ZOLL Medical Corporation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2021 American College of Cardiology Foundation",
year = "2021",
month = mar,
doi = "10.1016/j.jchf.2020.09.015",
language = "English (US)",
volume = "9",
pages = "179--189",
journal = "JACC: Heart Failure",
issn = "2213-1779",
publisher = "Elsevier BV",
number = "3",
}