Mitral Regurgitation and Increased Risk of All-Cause and Cardiovascular Mortality in Patients with Type 2 Diabetes.

Background: Mitral regurgitation is the most common heart valve disease in the general population, but little is known about the prevalence and prognostic implications of mitral regurgitation in patients with type 2 diabetes.

Methods: We retrospectively analyzed the data from 814 outpatients with type 2 diabetes who had undergone a conventional echocardiography for clinical reasons during the years 1992-2007. Mitral regurgitation was evaluated by using an integrated multiparametric echocardiographic approach. The study outcomes were all-cause and cardiovascular mortality.

Results: At baseline, 261 (32%) patients had mitral regurgitation (25% mild, 5% moderate, and 2% severe). Over a mean follow-up of 9 years, 120 (14%) patients died, 50 of them from cardiovascular causes. Compared with those without valve disease, patients with mild mitral regurgitation had a 3.3-fold increased risk of all-cause mortality, whereas those with moderate-to-severe mitral regurgitation had a 5.1-fold increased risk of all-cause mortality. Results remained statistically significant after adjustment for multiple potential confounders. Similar results were found for cardiovascular mortality.

Conclusions: Mitral regurgitation is a common pathologic condition in patients with type 2 diabetes and is independently associated with an increased risk of both all-cause and cardiovascular mortality, even if the severity of mitral regurgitation is mild.