Etiology and short-term prognosis of severe mitral regurgitation.

Purpose: To describe the etiology and to document the course of severe mitral regurgitation (MR).

Methods: Prospective registry of 272 patients diagnosed with chronic severe MR in an echocardiographic study.

Results: Mean age was 70.2 +/- 13.8 years and 143 patients were women (53%). The most frequent causes of regurgitation were rheumatic disease (72 patients; 26%), ischemic etiology (58; 21%), valve prolapse (57; 21%), and dilated cardiomyopathy (49; 18%). A total of 43 patients (16%) died during follow-up (mean 0.9 +/- 0.3 years, total 2,785 patient-months): 30 from cardiac causes, 9 from non-cardiac causes, and 4 from unknown causes. Actuarial transplant-free survival was 87% at 6 months, and 81% at 1 year. Renal disease, previous stroke, ischemic etiology, and poor left ventricular ejection fraction were independent predictors of mortality.

Conclusions: Rheumatic disease is still the main cause of severe MR in Spain. Patients with severe MR have advanced age and present poor short-term prognosis.