Which factors have an impact on occurrence, clinical and echocardiographic characteristics of idiopathic chordae rupture?

BACKGROUND

The aim of this study was to determine which risk factors have an influence on occurrence, clinical and echocardiographic characteristics of patients with idiopathic rupture of the chordae tendineae (RCT).

METHODS

The study included 149 patients with diagnosed RCT by transthoracic echocardiography: 90 (60.4%) patients with the idiopathic RCT and 59 (39.6%) subjects with a secondary RCT. Clinical and echocardiographic data were collected for each patient.

RESULTS

The univariate logistic regression analysis showed that age > or = 65 (OR 3.76, 95% CI; 1.94-6.18), arterial hypertension (HTA) (OR 7.7, 95% CI: 3.43-16.84), duration > or = 15 (OR 1.14, 95%: 1.04-1.24), uncontrolled HTA (OR 4.72, 95% CI: 2.03-7.39), diabetes (OR 3.22, 95%CI: 1.4-7.37), hypercholesterolemia (OR 1.52, 95% CI: 1.05-2.2), hypertriglyceridaemia (OR 1.99, 95% CI: 1.2-3.28), coronary (OR 5.11, 95% CI: 2.34-9.01) and carotid artery disease (OR 4.35, 95% CI: 1.87-6.89), renal failure (OR 7.25, 95% CI: 1.01-15.23), thickness of interventricular septum (OR 3.25, 95% CI: 1.44-7.58), posterior wall (OR 4.67, 95% CI: 2.21-9.13), and relative wall thickness (OR 2.87, 95% CI: 1.65-4.21) correlated with idiopathic RCT. The multiple logistic regression revealed age > or = 65 (OR 1.06, p < 0.001), HTA (OR 4.93, p = 0.001), HTA > or = 15 years (OR 1.35, p = 0.021), uncontrolled HTA (OR 2.28, p=0.007), coronary artery disease (OR 2.78, p = 0.004), and relative wall thickness (OR 3.45, p = 0.005) as independent predictors of idiopathic RCT.

CONCLUSION

Independent predictors of idiopathic RCT are advanced age, HTA, its duration, uncontrolled HTA, coronary artery disease, and relative wall thickness.