Long-term results of medicamentous therapy alone in patients with dilated cardiomyopathy complicated by severe mitral insufficiency

Abstract

The aim of this study was to assess survival rates and clinical outcomes in patients with dilated cardiomyopathy (DCM) and severe functional mitral regurgitation (FMR), treated with optimal guideline-directed medical therapy (GDMT). Materials and methods. After signing an informed consent, 84 patients with DCM and severe FMR were enrolled in the study. Concomitant tricuspid valve regurgitation was recorded in 82 (97.6 %) cases. The median NT-proBNP level was 2530 pg/ml (2123–3000 pg/ml). Results. Hospital mortality was 5 (6.0 %) cases. Heart transplantation was performed in 4 (5.1 %) patients; therefore long-term results were analyzed in 75 patients. During the mean follow-up period of 45.9 ± 17.6 months, the occurrence of lethal outcomes (all-cause death) was 60.0 %. The 1-, 3-, and 5-year actuarial survival rate was 84.0 %, 53.3 % and 40.0 %, respectively. Left ventricular ejection fraction and systolic pressure in the pulmonary artery were independently associated with long-term all-cause mortality. Conclusions. The study results demonstrate that the short-term and long-term mortality rates in patients with dilated cardiomyopathy and severe functional mitral regurgitation remain high despite the treatment with currently accepted pharmacological therapy. One possible method which would improve the treatment results is mitral valve surgery.

Keywords

• dilated cardiomyopathy
• mitral valve insufficiency
• long-term clinical outcome
• treatment outcome