PMID- 28169216
OWN - NLM
STAT- MEDLINE
DCOM- 20171101
LR  - 20171101
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 12
IP  - 16
DP  - 2017 Mar 20
TI  - Prognostic implication of post-MitraClip vena contracta area in heart failure 
      patients with functional mitral regurgitation.
PG  - 1946-1953
LID - EIJ-D-16-00190 [pii]
LID - 10.4244/EIJ-D-16-00190 [doi]
AB  - AIMS: Significant functional mitral regurgitation (FMR) in elderly heart failure 
      patients is increasingly being treated by MitraClip implantation. We sought to 
      assess the prognostic implications of the intraprocedural assessment of vena 
      contracta area (VCA) after MitraClip therapy in such patients. METHODS AND 
      RESULTS: MitraClip therapy with intraprocedural assessment of VCA was performed 
      in 97 heart failure patients (74+/-10 years; 66 men; left ventricular ejection 
      fraction [LVEF] 31+/-12%; 93 patients in New York Heart Association [NYHA] 
      functional Class III [n=59] or IV [n=34]; 86 patients with FMR severity 3+ [n=65] 
      or 4+ [n=21]). Ninety-one patients (94%) were discharged with FMR severity </=2+. 
      During a median follow-up of 13.4 (interquartile range 4.6-21.1) months, 32 
      patients died. Multivariable Cox regression identified increasing age (HR [95% 
      confidence interval]=1.05 [1.00-1.09], p=0.0395), a glomerular filtration rate 
      <50 ml/min/1.73 m(2) (HR=2.7 [1.3-5.7], p=0.0115), and post-MitraClip VCA >25 mm(2) 
      (HR=4.5 [2.1-9.5], p=0.0001) as independent predictors of mortality. CONCLUSIONS: 
      In heart failure patients with FMR undergoing MitraClip therapy, increasing age, 
      impaired baseline renal function and post-MitraClip VCA >25 mm(2) are strongly 
      associated with mortality. Post-MitraClip VCA may be used as intraprocedural 
      guidance with respect to patients' long-term outcome.
FAU - Alessandrini, Hannes
AU  - Alessandrini H
AD  - Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
FAU - Kreidel, Felix
AU  - Kreidel F
FAU - Schluter, Michael
AU  - Schluter M
FAU - Frerker, Christian
AU  - Frerker C
FAU - Schmidt, Tobias
AU  - Schmidt T
FAU - Thielsen, Thomas
AU  - Thielsen T
FAU - Schafer, Ulrich
AU  - Schafer U
FAU - Kuck, Karl-Heinz
AU  - Kuck KH
LA  - eng
PT  - Journal Article
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
SB  - IM
MH  - Aged
MH  - Female
MH  - Heart Failure/*etiology
MH  - Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/methods
MH  - Humans
MH  - Male
MH  - Mitral Valve Insufficiency/complications/*physiopathology/*surgery
MH  - Prognosis
MH  - Surgical Instruments
MH  - Treatment Outcome
EDAT- 2017/02/09 06:00
MHDA- 2017/11/02 06:00
CRDT- 2017/02/08 06:00
PHST- 2017/02/09 06:00 [pubmed]
PHST- 2017/11/02 06:00 [medline]
PHST- 2017/02/08 06:00 [entrez]
AID - EIJ-D-16-00190 [pii]
AID - 10.4244/EIJ-D-16-00190 [doi]
PST - ppublish
SO  - EuroIntervention. 2017 Mar 20;12(16):1946-1953. doi: 10.4244/EIJ-D-16-00190.