Abstract 14256: Prognostic Differences Between Men and Women With Significant Secondary Mitral Regurgitation

IntroductionSecondary mitral regurgitation (MR) is more frequent in men than in women. However, little is known about differences in prognosis between men and women with secondary MR. The objective of this study was to investigate the gender distribution and its impact on long-term prognosis in patients with secondary MR.MethodsPatients with significant secondary MR, of both ischemic and non-ischemic etiology, were identified through the departmental electronic patient files and retrospectively analyzed. The primary endpoint was all-cause mortality.ResultsA total of 698 patients (mean age 66±11 years) with significant secondary MR were included471 (67%) men and 227 (33%) women. Ischemic heart failure was significantly more common in men (61%), whereas non-ischemic heart failure was more prevalent in women (63%). Women had significantly smaller left ventricular (LV) volumes when compared to men and more preserved LV systolic function when assessed with LV global longitudinal strain (GLS; -8.5±4.1% vs. -7.5±3.6%; P= 0.004). A total of 308 patients (44%) received mitral valve (MV) intervention; 28% surgical MV repair and 16% percutaneous edge-to-edge MV repair. Women more often underwent surgical MV repair (34%) when compared to men (26%), whilst no differences were observed for percutaneous edge-to-edge MV repair. During a median follow-up of 57 [interquartile range 29-110] months, 373 (53%) patients died. Women showed significantly lower mortality rates at 1-, 2- and 5-year follow-up (9%, 16% and 33% vs. 10%, 20% and 42%) when compared to men (P= 0.001; Figure 1).ConclusionsAmong patients with secondary MR, women more frequently have non-ischemic heart failure as underlying mechanism and experience lower mortality rates when compared to men.