Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosis
Abstract Yeo’s index, the product of the mitral leaflet separation index and dimensionless index of mitral valve (MV), was recently described to accurately identify severe rheumatic mitral stenosis (MS). We assess the association between Yeo’s index and clinical outcomes in patients with rheumatic M...
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Nature Portfolio
2024-11-01
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| Online Access: | https://doi.org/10.1038/s41598-024-76534-3 |
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| author | Ryan Leow Tony Yi-Wei Li Meei-Wah Chan William K. F. Kong Siew-Pang Chan Kian-Keong Poh Ivandito Kuntjoro Ching-Hui Sia Tiong-Cheng Yeo |
| author_facet | Ryan Leow Tony Yi-Wei Li Meei-Wah Chan William K. F. Kong Siew-Pang Chan Kian-Keong Poh Ivandito Kuntjoro Ching-Hui Sia Tiong-Cheng Yeo |
| author_sort | Ryan Leow |
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| description | Abstract Yeo’s index, the product of the mitral leaflet separation index and dimensionless index of mitral valve (MV), was recently described to accurately identify severe rheumatic mitral stenosis (MS). We assess the association between Yeo’s index and clinical outcomes in patients with rheumatic MS. We studied 297 patients with rheumatic MS. Clinical and echocardiographic data were obtained from the electronic medical record and Yeo’s index was measured in all cases. The outcome studied was a composite of all cause death, heart failure (HF) hospitalisation, MV intervention and stroke or transient ischaemic attack. We also performed subgroup analysis of patients without pre-existing atrial fibrillation (AF) to assess for association with new onset AF. The median follow up was 6.3 years; 145 patients (48.8%) developed the composite outcome. Yeo’s index (p < 0.001), mitral valve area (MVA) by pressure half-time (PHT) (p = 0.028) and planimetry (p < 0.001), age (p = 0.016), history of diabetes mellitus (p = 0.029), previous HF (p = 0.021), left ventricular ejection fraction (p = 0.022), and pulmonary artery systolic pressure (p = 0.007) were univariately associated with the composite outcome. Yeo’s index remained independently associated with the composite outcome in multivariate analysis (p < 0.001, HR 0.094, 95% CI 0.260–0.340). This was primarily driven by MV intervention. In a subgroup analysis of patients without pre-existing AF, Yeo’s index was independently associated with new onset AF (p = 0.024, HR 0.354, 95% CI 0.143–0.874). This demonstrated that Yeo’s index was independently associated with clinical outcomes in patients with rheumatic MS which was mainly driven by MV intervention. |
| format | Article |
| id | doaj-art-bb3bfee942e347839e18d0bfb95d7a05 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-bb3bfee942e347839e18d0bfb95d7a052024-12-01T12:24:44ZengNature PortfolioScientific Reports2045-23222024-11-011411910.1038/s41598-024-76534-3Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosisRyan Leow0Tony Yi-Wei Li1Meei-Wah Chan2William K. F. Kong3Siew-Pang Chan4Kian-Keong Poh5Ivandito Kuntjoro6Ching-Hui Sia7Tiong-Cheng Yeo8Department of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeDepartment of Cardiology, National University Heart Centre, SingaporeAbstract Yeo’s index, the product of the mitral leaflet separation index and dimensionless index of mitral valve (MV), was recently described to accurately identify severe rheumatic mitral stenosis (MS). We assess the association between Yeo’s index and clinical outcomes in patients with rheumatic MS. We studied 297 patients with rheumatic MS. Clinical and echocardiographic data were obtained from the electronic medical record and Yeo’s index was measured in all cases. The outcome studied was a composite of all cause death, heart failure (HF) hospitalisation, MV intervention and stroke or transient ischaemic attack. We also performed subgroup analysis of patients without pre-existing atrial fibrillation (AF) to assess for association with new onset AF. The median follow up was 6.3 years; 145 patients (48.8%) developed the composite outcome. Yeo’s index (p < 0.001), mitral valve area (MVA) by pressure half-time (PHT) (p = 0.028) and planimetry (p < 0.001), age (p = 0.016), history of diabetes mellitus (p = 0.029), previous HF (p = 0.021), left ventricular ejection fraction (p = 0.022), and pulmonary artery systolic pressure (p = 0.007) were univariately associated with the composite outcome. Yeo’s index remained independently associated with the composite outcome in multivariate analysis (p < 0.001, HR 0.094, 95% CI 0.260–0.340). This was primarily driven by MV intervention. In a subgroup analysis of patients without pre-existing AF, Yeo’s index was independently associated with new onset AF (p = 0.024, HR 0.354, 95% CI 0.143–0.874). This demonstrated that Yeo’s index was independently associated with clinical outcomes in patients with rheumatic MS which was mainly driven by MV intervention.https://doi.org/10.1038/s41598-024-76534-3Mitral stenosisRheumatic heart diseaseYeo’s index |
| spellingShingle | Ryan Leow Tony Yi-Wei Li Meei-Wah Chan William K. F. Kong Siew-Pang Chan Kian-Keong Poh Ivandito Kuntjoro Ching-Hui Sia Tiong-Cheng Yeo Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosis Scientific Reports Mitral stenosis Rheumatic heart disease Yeo’s index |
| title | Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosis |
| title_full | Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosis |
| title_fullStr | Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosis |
| title_full_unstemmed | Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosis |
| title_short | Association of Yeo’s index with clinical outcomes in rheumatic mitral stenosis |
| title_sort | association of yeo s index with clinical outcomes in rheumatic mitral stenosis |
| topic | Mitral stenosis Rheumatic heart disease Yeo’s index |
| url | https://doi.org/10.1038/s41598-024-76534-3 |
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