Prevalence of Unsuspected and Significant Mitral and Aortic Regurgitation
published online 12 July 2007.
Objective
We sought to determine the prevalence of unsuspected, pre-existing valvular regurgitation in a large, heterogeneous population of patients referred for an echocardiogram.
Methods
The echocardiograms of 6851 consecutive individuals without suspected valve disease were reviewed. Regurgitant severity was graded using a clinical composite of published methods and multiple logistic analyses were used to model various clinical variables.
Results
The overall prevalence of moderate or greater mitral regurgitation (MR) was 11.7% in male patients and 12.5% in female patients. For mild or greater aortic insufficiency (AI), the prevalence was 18.9% in male patients and 19.7% in female patients. Both MR and AI increased exponentially as a function of age. Female sex predicted MR, but AI was sex neutral. Regurgitant severity increased with decreasing ejection fraction and body mass index, a history of hypertension, the presence of left ventricular hypertrophy, and valvular abnormalities.
Conclusions
The prevalence of unsuspected MR and AI is substantial, increases exponentially with age, and is predicted by commonly used clinical variables.
aDepartment of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio
bDepartment of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
cDepartment of Medicine, Cleveland, Ohio, Case Western Reserve University, Cleveland, Ohio.
Reprint requests: Brian D. Hoit, MD, Division of Cardiology, Case Western Reserve University, 11100 Euclid Ave, MS 5038, Cleveland, OH 44106-5038.
ABSTRACT