Clinical and echocardiographic differences between rheumatic and degenerative mitral stenosis
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction: Degenerative mitral stenosis (DMS) is frequently cited as increasing in prevalence in the developed world, although comparatively little is known about DMS in comparison to rheumatic mitral stenosis (RMS). Method: A retrospective observational study was conducted on 745 cases of native-valve mitral stenosis (MS) with median follow-up time of 7.25 years. Clinical and echocardiographic parameters were compared. Univariate and multivariate Cox regression analyses were performed for a composite of all-cause mortality and heart failure hospitalisation. Results: Patients with DMS compared to RMS were older (age, mean ± standard deviation: 69.6 ± 12.3 versus [vs] 51.6 ± 14.3 years, respectively; P<0.001) and a greater proportion had medical comorbidities such as diabetes mellitus (78 [41.9%] vs 112 [20.0%], P<0.001). The proportion of cases of degenerative aetiology increased from 1.1% in 1991–1995 to 41.0% in 2016–2017. In multivariate analysis for the composite outcome, age (hazard ratio [HR] 95% confidence interval [CI] of 1.032 [1.020–1.044]; P<0.001), diabetes mellitus (HR 1.443, 95% CI 1.068–1.948; P=0.017), chronic kidney disease (HR 2.043, 95% CI 1.470–2.841; P<0.001) and pulmonary artery systolic pressure (HR 1.019, 95% CI 1.010–1.027; P<0.001) demonstrated significant independent associations. The aetiology of MS was not independently associated with the composite outcome. Conclusion: DMS is becoming an increasingly common cause of native-valve MS. Despite numerous clinical differences between RMS and DMS, the aetiology of MS did not independently influence a composite of mortality or heart failure hospitalisation.
Authors: Ryan Leow, Hui Sia Ching, Tony Yi-Wei Li, Meei-Wah Chan, Eng How Lim, Li Min Julia Ng, Tiong-Cheng Yeo, Kian-Keong Poh, Huay Cheem Tan, William KF Fong
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409419800