# The Prevalence and Characteristics of Mitral Regurgitation in Heart Failure: A Chart Review Study

## TL;DR

This study finds that mitral regurgitation is common in heart failure patients, especially those with reduced ejection fraction, and identifies factors like heart structure and age that contribute to it.

## Contribution

The study provides new insights into the prevalence and risk factors of mitral regurgitation in Chinese heart failure patients, particularly across different ejection fraction subgroups.

## Key findings

- Mitral regurgitation prevalence was highest in heart failure patients with reduced ejection fraction (49.7%).
- Left atrium dimension and lower ejection fraction were significant predictors of mitral regurgitation across subgroups.
- Age and certain medications like digoxin were also associated with mitral regurgitation in specific heart failure subgroups.

## Abstract

Mitral regurgitation (MR) is one of the common
complications of heart failure (HF). The prevalence and characteristics of MR are
rarely investigated, especially in the Chinese population.

The purpose of this study was to determine the
prevalence and characteristics of non-organic MR in HF patients and subgroups
defined by ejection fraction.

A
single-center, hospital-based, and retrospective chart
review study included patients with heart failure admitted to the cardiovascular
department from January 2017 to April 2020. Demographic characteristics,
laboratory results, and echocardiogram results before discharge were analyzed in
different groups defined by left ventricular ejection fraction (EF) using
logistic regression and adjusted for confounders.

Finally, 2418 validated HF patients (age 67.2 ± 13.5 years; 68.03% men)
were included. The prevalence of MR was 32.7% in HF, 16.7% in HF with preserve
EF patients, 28.4% in HF with mid-range EF patients and 49.7% in HF with
reduced EF (HFrEF) patients. In the HF with preserved EF group, multivariable
logistic regression showed that 4 factors associated with MR including EF (odds
ratio (OR) 0.954 (0.928–0.981), p = 0.001),
left ventricular posterior wall thickness in diastolic
phase (LVPWd) (OR 0.274 (0.081–0.932), p = 0.038), left
atrium (LA) dimension (OR 2.049 (1.631–2.576), p < 0.001) and age (OR
1.024 (1.007–1.041), p = 0.007). In the HF with midrange EF group,
multivariable logistic regression showed that 3 factors associated with MR
including LA dimension (OR 2.009 (1.427–2.829), p < 0.001),
triglycerides (TG) (OR 0.552 (0.359–0.849), p = 0.007) and digoxin (OR
2.836 (1.624–4.951), p < 0.001). In the HFrEF group, multivariable
logistic regression showed that 7 factors associated with MR including EF (OR
0.969 (0.949–0.990), p = 0.004),
(OR 0.161 (0.067–0.387), p <
0.001), LA dimension (OR 2.289 (1.821–2.878), p < 0.001), age (OR
1.016 (1.004–1.027)), p = 0.009), TG (OR 0.746 (0.595–0.936),
p = 0.011), diuretics (OR 0.559 (0.334–0.934), p = 0.026) and
ICD (OR 1.898 (1.074–3.354), p = 0.027).

HF
patients had a high burden of MR, particularly in the HFrEF group. Worsen cardiac
structure (LA dimension and LVPWd) and function (EF), age, and medical treatment
strategy played essential roles in MR.