CMR-Analysis (including machine learning)

1357811 - Sex Differences in Functional Mitral Regurgitation Associations: A Cardiac Magnetic Resonance Study in Non-ischemic Cardiomyopathy Patients

Wednesday, January 25, 2023

Location: E-POSTER

Presenting Author(s)

DA

Danah Al-Deiri, MD

Research Fellow
Cleveland Clinic, United States

Primary Author(s)

DA

Danah Al-Deiri, MD

Research Fellow
Cleveland Clinic, United States

Co-Author(s)

SY

Salva R. Yurista, MD, PhD

Staff Scientist
Cleveland Clinic
Cleveland, Ohio, United States
DS

Donna Salam, MD

Research Fellow
Cleveland Clinic, United States
MT

Mustafa Turkmani, MD

Research fellow
Cleveland Clinic, United States
Debbie Kwon, MD

Staff Physician
Cleveland Clinic
Cleveland, Ohio, United States
TW

Tom Kai Ming Wang, MBChB MD

Cardiologist
Cleveland Clinic, United States
Scott Flamm, MD, FSCMR

Radiologist
Cleveland Clinic
Shaker Heights, Ohio, United States
WT

Wilson Tang, MD

Cardiologist
Cleveland Clinic, United States
Christopher Nguyen, PhD, FACC, FSCMR

Director
Cleveland Clinic
Cleveland, Ohio, United States

Disclosure(s):

Debbie Kwon, MD: No financial relationships to disclose

Christopher Nguyen, PhD, FSCMR: No financial relationships to disclose

Background: Functional mitral regurgitation (FMR) is a common complication of left ventricular dysfunction in both NICM and ICM cardiomyopathy patients. Previously, we have identified female sex as an independent predictor of FMR in NICM; however, sex specific predictors of FMR predictors have not been determined. This study compared the clinical and cardiac magnetic resonance (CMR) predictors of FMR stratified by sex.

Methods: We retrospectively studied patients with NICM (n=633) who underwent cardiac magnetic resonance imaging between April 2002 and December 2017. Female patients were 256 (40.4%) vs. male patients were 377 (59.6%). Clinical characteristics left atrial/ventricular volumes and function, late gadolinium enhancement and mitral valve geometry were assessed by CMR. Univariable and multivariable linear regression analysis was performed to determine their predictive value of FMR.

Results: Univariate and multivariate regression analysis of clinical and CMR imaging predictors are presented in Figure 1. Mean FMR regurgitant fraction (RF) was 15 (SD 14), and 13 (SD 13) in female and male, respectively. 26.17% of female patients and 23.60% of male patients had FMR RF fraction > 20. In women, left ventricle end diastolic volume index (LVEDVi) p< 0.001, and glomerular filtration rate (GFR) p=0.006 were the only independent predictors of FMR-RF. On the other hand, in men, atrial fibrillation (AF) and left ventricle ejection fraction LVEF (P < 0.001 for both), and older age (p < 0.035) were independent predictors of FMR-RF. LGE and mitral valve geometry were not significant predictors of FMR fraction for either sex.

Conclusion: Our study demonstrates significant sex differences in clinical and imaging characteristics associated with significant FMR in patients with non-ischemic cardiomyopathy. Further studies are needed to determine underlying biologic mechanisms.