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Eur Heart J Cardiovasc Imaging. 2018 May 1;19(5):503-507. doi: 10.1093/ehjci/jey011.

Overview of mitral regurgitation in Europe: results from the European Registry of mitral regurgitation (EuMiClip).

Author information

1
Department of Cardiology, CIBERCV, University of Alcala, Hospital Ramon y Cajal, Carretera de Colmenar Km 9, 100, 28034 Madrid, Spain.
2
Laboratory of Standard and Advanced Echocardiography, Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy.
3
Department of Cardiac, Vascular, and Thoracic Sciences, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy.
4
Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 Nieuwegein, Netherlands.
5
Department of Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland.
6
Cardiology Department, King's College Hospital, Denmark Hill, Brixton, London SE5 9RS, UK.
7
Division of Cardiology, Soroka Medical Center and Ben Gurion University of the Negev, Yitzhack I. Rager Blvd 151, 84101 Beersheba, Israel.
8
Department of Cardiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia.
9
Department of Cardiology, Attikon Hospital, Rimini 1, 124 62 Chaidari, Greece.
10
Department of Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland.
11
Department of Cardiology, Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland.
12
Department of Cardiology, University Hospital of Santiago de Compostela, Rúa Choupana, Santiago de Compostela, 15706 A Coruña, Spain.
13
Department of Cardiology, University Hospital of Virgen del Rocio, Av. Manuel Siurot, 41013 Seville, Spain.
14
Department of Cardiology, Hospital of Leon, Altos de Navas, 24071 León, Spain.
15
Department of Cardiology, University Hospital Reina Sofia, Avenida Menéndez Pidal, 14004 Córdoba, Spain.
16
Department of Cardiology, University Hospital Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
17
Cardiology Department, Thorax Institute, Hospital Clinic Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain.
18
Department of Cardiology, University Hospital Virgen Victoria, Campus de Teatinos, 29010 Málaga, Spain.
19
Cardiology Division, Department of Medicine, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041 Barcelona, Spain.
20
Department of Cardiology, University Francisco de Vitoria, Hospital La Zarzuela, Calle de Pleyades, 25, 28023 Madrid, Spain.

Abstract

Aims:

To determine the prevalence of mitral regurgitation (MR) in a large cohort of consecutive patients undergoing clinically indicated echocardiography and to examine the distribution of primary and secondary MR.

Methods and results:

All patients undergoing an echocardiographic study in 19 European centres within a 3-month period were prospectively included. MR assessment was performed as recommended by the European Association of Cardiovascular Imaging (EACVI). MR was classified according to mechanism as primary or secondary and aetiologies were reported. A total of 63 463 consecutive echocardiographic studies were reviewed. Any degree of MR was described in 15 501 patients. Concomitant valve disease of at least moderate grade was present in 28.5% of patients, being tricuspid regurgitation the most prevalent. In the subgroup of moderate and severe MR (n = 3309), 55% of patients had primary MR and 30% secondary MR. Both mechanisms were described in 14% of the studies. According to Carpentier's classification, 26.7% of MR were classified as I, 19.9% of MR as II, 22.4% of MR as IIIa, and 31.1% of MR as IIIb.

Conclusion:

To date, this is the largest echocardiography-based study to analyse the prevalence and aetiology distribution of MR in Europe. The burden of secondary MR was higher than previously described, representing 30% of patients with significant MR. In our environment, degenerative disease is the most common aetiology of primary MR (60%), whereas ischaemic is the most common aetiology of secondary MR (51%). Up to 70% of patients with severe primary MR may have a Class I indication for surgery. However, the optimal therapeutic approach for secondary MR remains uncertain.

Comment in

PMID:
29529191
DOI:
10.1093/ehjci/jey011
[Indexed for MEDLINE]

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