Frailty, Aging, and Risk of Adverse Outcomes in Mitral Valve Prolapse (FAR-OUT-MVP Study)

二尖瓣脱垂的虚弱、衰老和不良后果风险（FAR-OUT-MVP 研究）

基本信息

批准号：
10836297
负责人：
Jordan Blair Strom
金额：
$ 17.28万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10836297
关键词：
Accident and Emergency department Adverse event Age Aging Arrhythmia Atrial Fibrillation Attenuated Benign Blood flow Cardiac Cardiovascular system Case Mixes Communities Data Data Linkages Data Set Data Sources Databases Decision Making Development Disease Echocardiography Employee Endocarditis Enrollment Event Fibrosis Future General Population Heart Valve Diseases Heart failure Heterogeneity Homeostasis Image Impairment Implantable Defibrillators Individual Inpatients Institution Insurance Investigation Israel Left Link Magnetic Resonance Massachusetts Medical center Mitral Valve Mitral Valve Insufficiency Mitral Valve Prolapse Morbidity - disease rate Myocardial Myocardial Contraction National Heart, Lung, and Blood Institute Natural History Outcome Outpatients Patients Phenotype Physiological Population Prevalence Privatization Prognosis Provider Registries Reporting Risk Risk Factors Role Rupture Secondary to Severities Stressful Event Stretching Structure Survivors System Tissues Ventricular Ventricular Arrhythmia Vulnerable Populations adverse event risk adverse outcome aortic valve disorder cardiac magnetic resonance imaging cardiovascular risk factor cerebrovascular clinically relevant cohort frailty heart imaging high risk human old age (65+)imaging biomarker improved insight mitral valve replacement mortality mortality risk novel papillary muscle repaired stressor structured data sudden cardiac death

项目摘要

PROJECT SUMMARY Mitral valve prolapse (MVP) is a common cardiac valvular disease, with a prevalence of roughly 2-3% in the general population, associated with excess mitral valve or chordal tissue may predispose to the development of mitral regurgitation (MR) from leaflet malcoaptation and chordal rupture. This condition and its sequelae, detected on echocardiograms (TTEs) and cardiac magnetic resonance images (CMRs), has been previously felt to be associated with an overall benign prognosis. Recent evidence suggest a subset of individuals with MVP have an excess risk of cardiovascular and non-cardiovascular morbidity and mortality, including ventricular arrhythmias and sudden cardiac death. Despite known risks of MVP, it remains challenging to identify high risk subsets in need of further treatments such as implantable defibrillator use or mitral valve repair or replacement. Furthermore, disaggregating the risk of MVP from that of concomitant MR remains challenging at present. Moreover, while individual imaging biomarkers of risk have been identified, which of these independently influence MVP risk when considered together remains unclear. While relevant clinical risk factors including aging and frailty, “a state of increased vulnerability and reduced ability to maintain homeostasis after a stressful event resulting from an impairment in multiple physiologic systems,” have found to influence outcome risk in other valvular heart diseases, it remains unclear if aging and frailty modify the risk of MVP on adverse outcomes. This proposal leverages the unique linkage of two large data sources, structured datasets of TTE and CMR reports from Beth Israel Deaconess Medical Center, and all-payer statewide claims data from the Massachusetts Case Mix Dataset (MACM) to better evaluate the risk of MVP across the spectrum of age and frailty. In this study, we propose to directly link BIDMC TTE and CMR reports to MACM data to evaluate whether MVP is associated with a risk of mortality, cardiovascular morbidity (composite of heart failure, atrial fibrillation, cerebrovascular event, endocarditis), and need for mitral valve replacement or repair, and whether this risk relationship varies by age and frailty as well as operative status (receipt of mitral valve replacement or repair). Doing so, this study will provide greater insight into the role that aging and frailty may have on the risk of serious outcomes associated with MVP and build a unique registry of cardiac imaging information linked to outcome data that could be leveraged in the future to deepen understanding of MVP as well as other valvular heart diseases.

项目摘要二尖瓣脱垂（MVP）是一种常见的心脏瓣膜疾病，患病率约为2-3％一般人群与过度的斜瓣或弦组织有关二尖瓣反流（MR）从传单型和和弦破裂中。在超声心动图（TTE）和心脏磁共振图像（CMR）上检测到感觉与整体良性计划有关。 MVP有心血管和非心血管疾病和死亡率的过多风险，包括尽管已知的MVP风险确定需要进一步信任的高风险子集，例如可植入的偏降或二尖瓣阀门修复或更换。目前仍然具有挑战性。当考虑在一起时，哪个独立影响MVP风险临床危险因素包括纳入衰老和脆弱，“脆弱性的增加和维持能力降低的状态在多个生理系统中受损的压力损害发生压力后，体内平衡已找到为了影响其他瓣膜心脏疾病的结果风险，尚不清楚衰老和兄弟会是否改变了风险 MVP的不利结果。来自贝丝以色列执事医疗中心的TTE和CMR报告的结构化数据集和所有付款人全州索赔来自马萨诸塞州案例混合数据集（MACM）以更好地评估MVP的风险在这项研究中，我们在年龄和脆弱的情况下直接连接BIDMC TTE和CMR报告到MACM数据以评估MVP是否与死亡率，心血管疾病的风险有关（心力衰竭的复合，心房颤动，脑血管事件，心内膜炎）和二尖瓣的需求替换或维修，以及这种风险关系是否随着年龄和脆弱和手术状态而变化（二尖瓣更换或维修）。衰老和脆弱的作用可能会在与MVP相关的血清结局风险上具有与结果数据相关的心脏成像信息的独特注册表深化对MVP以及其他瓣膜心脏病的未来。

项目成果

期刊论文数量（25）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Moderate aortic stenosis: culprit or bystander?

DOI：
10.1136/openhrt-2021-001743
发表时间：
2022-01
期刊：
Open heart
影响因子：
2.7
作者：
Pankayatselvan V;Raber I;Playford D;Stewart S;Strange G;Strom JB
通讯作者：
Strom JB

Echocardiographic Progression of Peak Tricuspid Regurgitant Velocity Among Medicare Beneficiaries.

医疗保险受益人三尖瓣反流峰值速度的超声心动图进展。

DOI：
10.1016/j.jacadv.2023.100579
发表时间：
2023
期刊：
JACC. Advances
影响因子：
0
作者：
Kholdani,CyrusA;Choudhary,Gaurav;Furfaro,DavidM;Markson,LawrenceJ;Manning,WarrenJ;Strom,JordanB
通讯作者：
Strom,JordanB

The Association of Weekly Sonographer Feedback and Reduction in Sonographer Errors.

DOI：
10.1016/j.echo.2021.08.011
发表时间：
2021-11
期刊：
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
影响因子：
0
作者：
Fostello SE;Stout JL;Manning WJ;Strom JB
通讯作者：
Strom JB

Retrospective evaluation of echocardiographic variables for prediction of heart failure hospitalization in heart failure with preserved versus reduced ejection fraction: A single center experience.

DOI：
10.1371/journal.pone.0244379
发表时间：
2020
期刊：
PloS one
影响因子：
3.7
作者：
Hammond MM;Shen C;Li S;Kazi DS;Sabe MA;Garan AR;Markson LJ;Manning WJ;Klein AL;Nagueh SF;Strom JB
通讯作者：
Strom JB

Association of Frailty With Treatment Selection and Long-Term Outcomes Among Patients With Chronic Limb-Threatening Ischemia.

DOI：
10.1161/jaha.121.023138
发表时间：
2021-12-21
期刊：
JOURNAL OF THE AMERICAN HEART ASSOCIATION
影响因子：
5.4
作者：
Butala, Neel M.;Raja, Aishwarya;Xu, Jiaman;Strom, Jordan B.;Schermerhorn, Marc;Beckman, Joshua A.;Shishehbor, Mehdi H.;Shen, Changyu;Yeh, Robert W.;Secemsky, Eric A.
通讯作者：
Secemsky, Eric A.