Article (Scientific journals)
Clinical and Hemodynamic Effects of Percutaneous Edge-to-Edge Mitral Valve Repair in Atrial Versus Ventricular Functional Mitral Regurgitation.
Claeys, Marc J; Debonnaire, Philippe; Bracke, Veronique et al.
2021In American Journal of Cardiology, 161, p. 70-75
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Keywords :
Aged; Cardiac Catheterization/methods; Echocardiography; Female; Follow-Up Studies; Heart Valve Prosthesis Implantation/methods; Heart Ventricles/diagnostic imaging/physiopathology; Hemodynamics/physiology; Humans; Male; Mitral Valve/diagnostic imaging/physiopathology/surgery; Mitral Valve Insufficiency/diagnosis/physiopathology/surgery; Retrospective Studies; Treatment Outcome
Abstract :
[en] The present study aims to assess the clinical and hemodynamic impact of percutaneous edge-to-edge mitral valve repair with MitraClip in patients with atrial functional mitral regurgitation (A-FMR) compared with ventricular functional mitral regurgitation (V-FMR). Mitral regurgitation (MR) grade, functional status (New York Heart Association class), and major adverse cardiac events (MACE; all-cause mortality or hospitalization for heart failure) were evaluated in 52 patients with A-FMR and in 307 patients with V-FMR. In 56 patients, hemodynamic assessment during exercise echocardiography was performed before and 6 months after intervention. MR reduction after MitraClip implantation was noninferior in A-FMR compared with V-FMR (MR grade ≤2 at 6 months in 94% vs 82%, respectively, p <0.001 for noninferiority) and was associated with improvement of functional status (New York Heart Association class ≤2 at 6 months in 90% vs 80%, respectively, p = 0.2). Hemodynamic assessment revealed that cardiac output at 6 months was higher in A-FMR at rest (5.1 ± 1.5 L/min vs 3.8 ± 1.5 L/min, p = 0.002) and during peak exercise (7.9 ± 2.4 L/min vs 6.1 ± 2.1 L/min, p = 0.02). In addition, the reduction in systolic pulmonary artery pressure at rest was more pronounced in A-FMR: Δ SPAP -13.1 ± 15.1 mm Hg versus -2.2 ± 13.3 mm Hg (p = 0.03). MACE rate at follow-up was significantly lower in A-FMR versus V-FMR, with an adjusted odds ratio of 0.46 (95% confidence interval 0.24 to 0.88), which was caused by a reduction in hospitalization for heart failure. In conclusion, percutaneous edge-to-edge mitral valve repair with MitraClip is at least as effective in A-FMR as in V-FMR in reducing MR. However, the hemodynamic improvement and reduction of MACE were significantly better in A-FMR.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Claeys, Marc J;  Dept of cardiology, Antwerp University Hospital, Edegem, Belgium. Electronic
Debonnaire, Philippe;  Dept of cardiology, Hospital Sint-Jan Brugge, Bruges, Belgium.
Bracke, Veronique;  Dept of cardiology, Antwerp University Hospital, Edegem, Belgium.
Bilotta, Giada;  Dept of cardiology, Antwerp University Hospital, Edegem, Belgium.
Shkarpa, Nikol;  Dept of cardiology, Antwerp University Hospital, Edegem, Belgium.
Vanderheyden, Marc;  Dept of cardiology, OLV Hospital Aalst, Aalst, Belgium.
Coussement, Patrick;  Dept of cardiology, Hospital Sint-Jan Brugge, Bruges, Belgium.
Vanderheyden, Jan;  Dept of cardiology, Hospital Sint-Jan Brugge, Bruges, Belgium.
de Heyning, Caroline M Van;  Dept of cardiology, Antwerp University Hospital, Edegem, Belgium.
Cosyns, Bernard;  Dept of cardiology, Brussels University Hospital, Brussels, Belgium.
Pouleur, Anne-Catherine;  Dept of cardiology, Cliniques Universitaires Saint Luc, Brussels, Belgium.
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Paelinck, Bernard P;  Dept of cardiology, Antwerp University Hospital, Edegem, Belgium.
Ferdinande, Bert;  Dept of Cardiology, University Hospital Leuven, Katholieke Universiteit Leuven,
Dubois, Christophe;  Dept of Cardiology, Hospital Oost-Limburg, Genk, Belgium.
More authors (5 more) Less
Language :
English
Title :
Clinical and Hemodynamic Effects of Percutaneous Edge-to-Edge Mitral Valve Repair in Atrial Versus Ventricular Functional Mitral Regurgitation.
Publication date :
15 December 2021
Journal title :
American Journal of Cardiology
ISSN :
0002-9149
eISSN :
1879-1913
Publisher :
Elsevier, New York, Us ny
Volume :
161
Pages :
70-75
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright © 2021 Elsevier Inc. All rights reserved.
Available on ORBi :
since 24 May 2022

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