LONG-TERM PROGNOSIS OF HEART FAILURE DUE TO MITRAL VALVE DISEASE IN WOMAN AND MEN

• Grant number: 24/23200-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2025
• End date: March 31, 2026
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Antonio de Padua Mansur
• Grantee: Giovanna Silva Machado
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Heart failure (HF) is a determining factor for higher mortality in patients withsignificant mitral valve disease (MV), with dyspnea being the primary symptom,indicating surgical intervention in these cases. However, the scientific literaturepresents scarce data on long-term prognostic differences and predictors ofmortality in men and women with HF associated with MV. This retrospectivestudy will analyze a cohort of 784 outpatients diagnosed with MV between 2009and 2023. The main objective is to evaluate baseline factors, including clinicalcharacteristics and echocardiographic findings, to investigate all-cause mortalityand identify predictors of death in men and women with HF associated with MV.The clinical parameters evaluated include age, medication use, prevalence ofcomorbidities, and history of cardiac surgical interventions. The comorbiditiesinvestigated are coronary artery disease, diabetes mellitus, chronic kidneydisease, atrial fibrillation, acute myocardial infarction, and stroke. Thepharmacological analysis will consider the use and doses of medications suchas angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers,beta-blockers, spironolactone, diuretics (thiazide and loop), and anticoagulants.The cardiac interventions to be evaluated include percutaneous intervention,valve surgery, and pacemaker implantation. In addition, the echocardiographicdata analyzed included left ventricular ejection fraction, left ventricular systolicdiameter, and systolic pressure in the pulmonary artery. These parameters willbe collected from echocardiograms performed at the beginning of the follow-upand the end of the analysis period. The primary outcome will be all-causemortality, the data for which will be obtained through medical records andconsultation with the Federal Revenue Service registry. Survival analysis will beconducted using the Kaplan-Meier method, while predictors of mortality will beassessed using the Cox proportional hazards model, with adjustments forvariables such as gender, age, and presence of comorbidities. This study seeksto fill relevant gaps in the literature by providing data on prognostic differencesand predictors of mortality between men and women with HF associated withMV. The results obtained may contribute to the formulation of moreindividualized and effective therapeutic strategies, optimizing the clinicalmanagement of this population.