{"id":"794fdf201007","type":"article","url":"https://hartvaat.nl/2026/02/10/welke-hartfalenpatienten-ontwikkelen-ernstige-mitralisinsufficientie-voorspellen/","title":"Welke hartfalenpatiënten ontwikkelen ernstige mitralisinsufficiëntie? Voorspellende factoren","title_en":"Factors associated with the development of severe mitral regurgitation in patients with heart failure","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","dapa-hf","hfmref","hfpef","hfref","myocardinfarct","nt-probnp","pathfinder-trial","step-hfpef","vrouwen"],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003920?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003920?rss=1","authors":["Ahmed","F.","Youngson","E.","Sasikumar","A.","Ezekowitz","J. A.","Fine","N.","McAlister","F. A.","Howlett","J. G.","Miller","R. J. H."],"significance":6,"published":"2026-02-10","source_date":"2026-02-10","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/mitralistenose/","https://hartvaat.nl/kennis/cardiometabool/obstructief-slaapapneu-en-hart/"],"congress":"","summary_en":"Patients with heart failure (HF) and severe mitral regurgitation (MR) have poor outcomes; early recognition could enable timely intervention. In this study, 7,391 HF patients with at least two echocardiograms (≥6 months apart) were analysed to find factors associated with progression to severe MR. Over a median 1.4 years, 4.8% developed severe MR. Besides baseline MR severity, atrial fibrillation (aOR 1.52), ischaemic heart disease (aOR 1.44), hypertension (aOR 1.35) and larger left ventricular end-diastolic dimension (aOR 1.36 per cm) were associated with more progression. Beta-blocker use was associated with less progression (aOR 0.74). These factors can help identify HF patients needing closer echocardiographic follow-up and timely access to interventions.","created":"2026-07-03T10:32:25Z","updated":"2026-07-03T18:39:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Patiënten met hartfalen (HF) en ernstige mitralisinsufficiëntie (MI) hebben een slechte prognose; vroege herkenning kan tijdige interventie mogelijk maken. In deze studie werden 7.391 HF-patiënten met minstens twee echo's (≥6 maanden uit elkaar) geanalyseerd om factoren te vinden die samenhangen met progressie naar ernstige MI. Over een mediaan van 1,4 jaar ontwikkelde 4,8% ernstige MI. Naast de uitgangsernst van de MI waren atriumfibrilleren (aOR 1,52), ischemische hartziekte (aOR 1,44), hypertensie (aOR 1,35) en een grotere linkerventrikel-einddiastolische diameter (aOR 1,36 per cm) geassocieerd met meer progressie. Het gebruik van een bètablokker ging juist gepaard met minder progressie (aOR 0,74). Deze factoren kunnen helpen om HF-patiënten te identificeren die nauwere echocardiografische follow-up en tijdige toegang tot interventies nodig hebben.","abstract_original":"Background\n

Patients with heart failure (HF) and severe mitral regurgitation (MR) have poor outcomes. Early identification could allow physicians to consider interventions that may improve outcomes. We identified factors associated with progression to severe MR in patients with HF.

\n\nMethods\n

A total of 11 521 patients with HF and MR were screened, out of which we identified 7391 patients with a clinical diagnosis of HF and at least two echocardiograms at least 6 months apart. We excluded patients without a documented severity of MR at initial (n=1840) or follow-up (n=960) echocardiogram and those with severe MR at initial echocardiogram (n=450). We evaluated factors associated with the development of either moderate to severe or severe MR using multivariable logistic regression analysis.

\n\nResults\n

A total of 7391 patients were included in the study, 4173 (56.5%) male, and median age 75 (IQR (IQR) 64–83). In total, 357 (4.8%) patients developed severe MR on the follow-up echocardiogram at a median of 1.4 years (IQR 0.9–2.4). In addition to baseline MR severity, atrial fibrillation (adjusted OR (aOR)1.52), ischaemic heart disease (aOR 1.44), hypertension (aOR 1.35) and higher left ventricular end-diastolic dimension (aOR 1.36 per 1 cm) were associated with increased progression to severe MR. Beta-blocker prescription was associated with reduced progression to severe MR (aOR 0.74).

\n\nConclusions\n

We identified several factors associated with the progression to severe MR in patients with HF. This information could be used by clinicians to identify patients who require closer echocardiographic follow-up and access to appropriate early interventions.

\n"}