Concomitant Mitral Regurgitation in Severe Aortic Stenosis - A Report From the CURRENT AS Registry

Circ J. 2022 Feb 25;86(3):427-437. doi: 10.1253/circj.CJ-21-0054. Epub 2021 Jul 16.

Abstract

Background: The clinical significance of concomitant mitral regurgitation (MR) has not been well addressed in patients with severe aortic stenosis (AS).

Methods and results: We analyzed 3,815 patients from a retrospective multicenter registry of severe AS in Japan (CURRENT AS registry). We compared the clinical outcomes between patients with moderate/severe MR and with none/mild MR according to the initial treatment strategy (initial aortic valve replacement [AVR] or conservative strategy). The primary outcome measure was a composite of aortic valve-related death or heart failure hospitalization. At baseline, moderate/severe MR was present in 227/1,197 (19%) patients with initial AVR strategy and in 536/2,618 (20%) patients with a conservative strategy. The crude cumulative 5-year incidence of the primary outcome measure was significantly higher in patients with moderate/severe MR than in those with none/mild MR, regardless of the initial treatment strategy (25.2% vs. 14.4%, P<0.001 in the initial AVR strategy, and 63.3% vs. 40.7%, P<0.001 in the conservative strategy). After adjusting confounders, moderate/severe MR was not independently associated with higher risk for the primary outcome measure in the initial AVR strategy (hazard ratio [HR] 1.11, 95% confidence interval [CI] 0.67-1.83, P=0.69), and in the conservative strategy (HR 1.13, 95% CI 0.93-1.37, P=0.22).

Conclusions: Concomitant moderate/severe MR was not independently associated with higher risk for the primary outcome measure regardless of the initial treatment strategy.

Keywords: Aortic stenosis; Aortic valve replacement; Mitral regurgitation.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / complications
  • Aortic Valve Stenosis* / diagnostic imaging
  • Aortic Valve Stenosis* / surgery
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Humans
  • Mitral Valve Insufficiency* / complications
  • Mitral Valve Insufficiency* / diagnostic imaging
  • Mitral Valve Insufficiency* / epidemiology
  • Registries
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome