Mitral-specific cardiac damage score (m-CDS) predicts risk of death in functional mitral regurgitation: a study from the National Echo Database of Australia

Loading...
Thumbnail Image
File version

Version of Record (VoR)

Author(s)
Moonen, A
Celermajer, DS
Ng, MKC
Strange, G
Playford, D
Stewart, S
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2024
Size
File type(s)
Location
Abstract

Aims We set out to explore associations between a ‘mitral-specific’ cardiac damage score (m-CDS) and survival outcomes in mitral regurgitation (MR) and compare the performance of the m-CDS and an ‘aortic-specific’ CDS (a-CDS) in patients with MR within the large National Echo Database of Australia. Methods Among 620 831 unique adults investigated with echocardiography, there were 17 658 individuals (3.1%) with moderate or greater functional MR (aged 76±13 years, 51% female) who met inclusion criteria. A randomly selected cohort of 5000 of these patients was used to test seven different CDS models for prediction of subsequent all-cause mortality during an average 3.8-year follow-up. The best-performing CDS model in the derivation cohort was then applied to a validation cohort of the remaining 12 658 individuals (aged 76±13 years, 51% female). Results The best-performing m-CDS model stratified the full cohort into Stage 0: control (1046 patients, 8%); Stage 1: left atrial damage (3416 patients, 27%); Stage 2: left ventricular damage (3352 patients, 26%); Stage 3: right ventricular damage (1551 patients, 12%) and Stage 4: pulmonary hypertension (3293 patients, 26%). Increasing m-CDS stage was consistently and incrementally associated with both all-cause and cardiovascular mortality at 1 year, 5 years and all-time and remained so after adjustment for increasing age and severity of MR, with a ~35% increase in mortality for each increase in CDS stage (p<0.001). Conclusion A m-CDS was robustly and incrementally associated with short-, medium- and long-term risk of all-cause and cardiovascular mortality in patients with functional MR in this large registry study.

Journal Title

Open Heart

Conference Title
Book Title
Edition
Volume

11

Issue

2

Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)

NHMRC

Grant identifier(s)

APP1055214

Rights Statement
Rights Statement

© 2024, The Author(s). Published by BMJ Publishing Group Ltd. This article is available under the Creative Commons CC-BY-NC 4.0 license and permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.

Item Access Status
Note
Access the data
Related item(s)
Subject
Persistent link to this record
Citation

Moonen, A; Celermajer, DS; Ng, MKC; Strange, G; Playford, D; Stewart, S, Mitral-specific cardiac damage score (m-CDS) predicts risk of death in functional mitral regurgitation: a study from the National Echo Database of Australia, Open Heart, 2024, 11 (2), pp. e002841

Collections