Table 2.
Baseline echocardiographic characteristics of the study population as per cardiac damage staging classification
| Variables | Stage 0 (n = 37; 10.9%) | Stage 1 (n = 43; 12.7%) | Stage 2 (n = 199; 58.9%) | Stage 3 (n = 38; 11.2%) | Stage 4 (n = 21; 6.2%) | p value |
|---|---|---|---|---|---|---|
| Prolapse, n (%) | 35 (95) | 35 (81) | 186 (94) | 34 (90) | 18 (86) | 0.09 |
| Flail, n (%) | 5 (14) | 8 (19) | 76 (38) | 11 (29) | 6 (29) | 0.01 |
| Affected leaflet, n (%) (n = 295) | 0.03 | |||||
| Anterior leaflet | 3 (9) | 9 (28) | 19 (10) | 2 (6) | 3 (19) | |
| Posterior leaflet | 21 (66) | 19 (59) | 138 (76) | 28 (82) | 8 (50) | |
| Bileaflet | 7 (22) | 4 (13) | 24 (13) | 4 (12) | 5 (31) | |
| MR severity | <0.001 | |||||
| Moderate, n (%) | 33 (89) | 32 (74) | 96 (48) | 17 (45) | 9 (43) | |
| Severe, n (%) | 4 (11) | 11 (26) | 103 (52) | 21 (55) | 12 (57) | |
| PISA EROA, cm2 (n = 253) | 0.28 ± 0.14 | 0.28 ± 0.14 | 0.45 ± 0.24 | 0.38 ± 0.23 | 0.45 ± 0.26 | <0.001 |
| Doppler EROA, cm2 (n = 239) | 0.29 ± 0.14 | 0.26 ± 0.13 | 0.51 ± 0.18 | 0.48 ± 0.25 | 0.41 ± 0.23 | <0.001 |
| Mean EROA, cm2 (n = 257) | 0.29 ± 0.13 | 0.27 ± 0.12 | 0.48 ± 0.18 | 0.45 ± 0.24 | 0.43 ± 0.21 | <0.001 |
| PISA RV, mL (n = 253) | 46 ± 21 | 48 ± 24 | 66 ± 28 | 62 ± 35 | 68 ± 38 | <0.001 |
| Doppler RV, mL (n = 253) | 48 ± 19 | 48 ± 30 | 69 ± 32 | 75 ± 41 | 57 ± 37 | <0.001 |
| Mean RV, mL (n = 264) | 47 ± 16 | 49 ± 26 | 67 ± 24 | 74 ± 37 | 64 ± 29 | <0.001 |
| LV cardiac output, L/min | 4.8 ± 1.0 | 4.7 ± 1.2 | 4.3 ± 1.2 | 3.8 ± 1.0 | 3.7 ± 1.3 | <0.001 |
| LVEDD, mm | 46 ± 4 | 50 ± 4 | 57 ± 6 | 51 ± 6 | 54 ± 9 | - |
| LVEDD index, mm/m2 | 26 ± 3 | 28 ± 3 | 31 ± 4 | 30 ± 4 | 29 ± 5 | - |
| LVESD, mm | 27 ± 4 | 30 ± 5 | 34 ± 7 | 31 ± 6 | 36 ± 11 | - |
| LVESD index, mm/m2 | 15 ± 3 | 17 ± 3 | 19 ± 4 | 18 ± 3 | 19 ± 6 | - |
| LVSV, mL | 68 ± 12 | 72 ± 14 | 62 ± 15 | 54 ± 14 | 52 ± 15 | <0.001 |
| LVSV index, mL/m2 | 38 ± 6 | 40 ± 9 | 33 ± 7 | 32 ± 8 | 28 ± 8 | <0.001 |
| Simpson LVEF, % (n = 295) | 65 ± 7 | 67 ± 6 | 66 ± 6 | 65 ± 6 | 63 ± 10 | 0.58 |
| Forward LVEF, % | 69 ± 7 | 63 ± 14 | 38 ± 9 | 47 ± 19 | 39 ± 15 | - |
| LA volume index, mL/m2 (n = 283) | 31 ± 5 | 37 ± 9 | 53 ± 21 | 47 ± 14 | 60 ± 46 | - |
| SPAP, mmHg (n = 259) | 32 ± 7 | 33 ± 7 | 33 ± 7 | 48 ± 15 | 31 ± 8 | - |
| TAPSE, mm (n = 233) | 24 ± 3 | 25 ± 4 | 26 ± 5 | 24 ± 3 | 17 ± 5 | - |
| E/A ratio (n = 262) | 1.3 ± 0.5 | 1.3 ± 0.5 | 1.8 ± 0.7 | 1.5 ± 0.5 | 1.4 ± 0.6 | <0.001 |
| E/e’ ratio (n = 258) | 10.3 ± 3.1 | 10.5 ± 3.6 | 11.5 ± 4.8 | 13.3 ± 4.8 | 10.5 ± 4.6 | 0.17 |
| S′, cm/s (n = 215) | 14.3 ± 3.1 | 14.8 ± 3.4 | 15.2 ± 3.0 | 15.8 ± 3.5 | 11.2 ± 4.1 | - |
| TR ≥ moderate, n (%) | 0 (0) | 0 (0) | 0 (0) | 28 (74) | 2 (10) | - |
Notes. Continuous data are mean ± SD or median (interquartile range). Categorical data are n (%). Bold indicates statistical significance.
EROA = effective regurgitant orifice area, LA = left atrium, LV = left ventricular, LVEDD = LV end-diastolic diameter, LVEF = LV ejection fraction, LVESD = LV end-systolic diameter, LVSV = LV stroke volume, MR = mitral regurgitation, PISA = proximal isovelocity surface area, RV = regurgitant volume, S’ = tricuspid annulus systolic velocity, SPAP = systolic pulmonary artery pressure, TAPSE = tricuspid annular plane systolic excursion, TR = tricuspid regurgitation.