ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT CỤC NGẮN HẠN TRÊN BỆNH NHÂN SUY TIM CẤP CÓ KÈM HỞ VAN HAI LÁ THỨ PHÁT NHẬP VIỆN TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Secondary mitral regurgitation (MR) is commonly observed in patients with acute heart failure (AHF), especially in those with reduced left ventricular ejection fraction (LVEF). This condition not only reflects the degree of left ventricular remodeling but also exacerbates hemodynamic burden and is associated with poor prognosis, including mortality and hospital readmission. Global studies have shown that moderate-to-severe secondary MR significantly increases the risk of adverse clinical events. However, data on its prognostic value in AHF patients in Vietnam remain limited. Objective: To assess the association between the severity of secondary MR and all-cause mortality or heart failure readmission within 30 days of hospital admission. Methods: A cross-sectional descriptive study was conducted on patients with AHF and secondary MR admitted from November 2023 to June 2024. Clinical and paraclinical characteristics, MR severity, and in-hospital mortality were analyzed. Univariate logistic regression was used to identify associated factors. Results: A total of 61 AHF patients with secondary MR were enrolled. The median age was 61 ± 15 years, with a predominance of males (57.4%). Ischemic heart disease was the leading cause of heart failure (60.7%). The mean LVEF was 26.3 ± 7.9%, and the median NT-proBNP level was 10,312 (4,655–21,852) pg/mL. During the study period, 24 patients (39.3%) experienced the composite outcome of all-cause mortality or heart failure readmission within 30 days: 14 deaths (22.9%) and 10 readmissions (16.4%). Univariate logistic regression identified moderate-to-severe secondary MR as an independent predictor of the composite outcome (OR = 4.1 [1.8–20.5], p = 0.048). Conclusion: Moderate-to-severe secondary MR is a significant prognostic factor for short-term adverse outcomes in patients hospitalized with AHF. Early identification of MR severity upon admission is crucial for optimizing management strategies and improving prognosis.