Trial Outcomes & Findings for Left Atrial Distensibility to Predict Left Ventricular Filling Pressure and Prognosis in Patients With Severe Mitral Regurgitation (NCT NCT01172184)

NCT ID: NCT01172184

Last Updated: 2011-06-07

Results Overview

Since left ventricular filling pressure more than 15 mmHg indicated poor ventricular compliance and more cardiovascular event in many prior reports, the current study used it as the threshold. Otherwise, the correlation between left ventricular filling pressure and left atrial distensibility was assessed. ROC curve was used to estimate the best cut-off point of left atrial distensibility for predicting left ventricular filling pressure more than 15 mmHg.

Recruitment status

COMPLETED

Target enrollment

111 participants

Primary outcome timeframe

1 year

Results posted on

2011-06-07

Participant Flow

The present study enrolled 111 patients with severe mitral regurgitation (MR) who had undergone cardiac catheterization in Kaohsiung veterans general hospital.

Participant milestones

Participant milestones
Measure
Patients With Either Chronic or Acute Mitral Regurgitation
Overall Study
STARTED
111
Overall Study
COMPLETED
111
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Left Atrial Distensibility to Predict Left Ventricular Filling Pressure and Prognosis in Patients With Severe Mitral Regurgitation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Patients With Either Chronic or Acute Mitral Regurgitation
n=111 Participants
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
61 Participants
n=5 Participants
Age, Categorical
>=65 years
50 Participants
n=5 Participants
Age Continuous
68 years
STANDARD_DEVIATION 18 • n=5 Participants
Sex: Female, Male
Female
56 Participants
n=5 Participants
Sex: Female, Male
Male
55 Participants
n=5 Participants
Region of Enrollment
Taiwan
111 participants
n=5 Participants

PRIMARY outcome

Timeframe: 1 year

Population: Severe mitral regurgitation affects the accuracy of left ventricular filling pressure estimated by tissue Doppler imaging. Therefore, we conducted this study using left atrial parameters to assess left ventricular filling pressure in patients with severe mitral regurgitation.

Since left ventricular filling pressure more than 15 mmHg indicated poor ventricular compliance and more cardiovascular event in many prior reports, the current study used it as the threshold. Otherwise, the correlation between left ventricular filling pressure and left atrial distensibility was assessed. ROC curve was used to estimate the best cut-off point of left atrial distensibility for predicting left ventricular filling pressure more than 15 mmHg.

Outcome measures

Outcome measures
Measure
Patients With Either Chronic or Acute Mitral Regurgitation
n=111 Participants
Left Ventricular Filling Pressure More Than 15 mmHg Measured by Left Ventricular Catheterization
25.5 mmHg
Standard Deviation 5.7

SECONDARY outcome

Timeframe: baseline and 1 year

After operation, patients received continuous EKG monitor during the ICU stay. After transfer to ordinary ward, patients received 2 times of EKG record per day and another EKG would be done if patients felt palpitation and irregular heart beats were found by nursing staffs. The event of atrial fibrillation (Af) was defined as irregular irregular heart beats which was lack of p wave and last for more than 30 seconds. The relationship between left atrial distensibility and post-operative Af was analysed. ROC curve was used to assess the best cutoff value of left atrial distensibility.

Outcome measures

Outcome measures
Measure
Patients With Either Chronic or Acute Mitral Regurgitation
n=111 Participants
Number of Participants With Post-operation Atrial Fibrillation
36 participants

SECONDARY outcome

Timeframe: 1-2 years

After discharge from index hospitalization of surgical intervention, heart failure with rehospitalization will be assessed. Heart failure with re-hospitalization was documented by at least one of the following: worse exercise tolerance and respiratory distress with NYHA class III or IV symptoms, presence of pulmonary rales, or chest radiography showing pulmonary congestion, which needed an augmented decongestive regimen during an in-hospital stay. The correlation between left atrial distensibility and heart failure was analyzed. ROC curve was used to estimate the best cut-off point.

Outcome measures

Outcome measures
Measure
Patients With Either Chronic or Acute Mitral Regurgitation
n=111 Participants
Number of Participants With Heart Failure Requiring Rehospitalization During Follow-up Period
9 participants

Adverse Events

Patients With Either Chronic or Acute Mitral Regurgitation

Serious events: 9 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Patients With Either Chronic or Acute Mitral Regurgitation
n=111 participants at risk
Cardiac disorders
Heart failure requiring rehospitalizaion
8.1%
9/111 • All patients with severe mitral regurgitation received mitral valve replacement during index hospitalization. In-hospital mortality, and post-operative atrial fibrillation were recorded. The mean hospital course was 13 days.
After discharge from index hospitalization, patients received regular follow-up for heart failure event requiring rehospitalization for 1 year.

Other adverse events

Other adverse events
Measure
Patients With Either Chronic or Acute Mitral Regurgitation
n=111 participants at risk
Blood and lymphatic system disorders
minor bleeding event
1.8%
2/111 • Number of events 2 • All patients with severe mitral regurgitation received mitral valve replacement during index hospitalization. In-hospital mortality, and post-operative atrial fibrillation were recorded. The mean hospital course was 13 days.
After discharge from index hospitalization, patients received regular follow-up for heart failure event requiring rehospitalization for 1 year.

Additional Information

Dr. Shih-Hung Hsiao

Kaohsiung veterans general hospital

Phone: 886-7-3422121

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place