PMID- 32861652
OWN - NLM
STAT- MEDLINE
DCOM- 20210827
LR  - 20240117
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 14
IP  - 4
DP  - 2021 Apr
TI  - Impact of Proportionality of Secondary Mitral Regurgitation on Outcome After 
      Transcatheter Mitral Valve Repair.
PG  - 715-725
LID - S1936-878X(20)30620-3 [pii]
LID - 10.1016/j.jcmg.2020.05.042 [doi]
AB  - OBJECTIVES: The purpose of this paper was to evaluate the impact of 
      proportionality of secondary mitral regurgitation (SMR) in a large real-world 
      registry of transcatheter edge-to-edge mitral valve repair (TMVr) BACKGROUND: 
      Differences in the outcomes of recent randomized trials of TMVr for SMR may be 
      explained by the proportionality of SMR severity to left ventricular (LV) volume. 
      METHODS: The ratio of pre-procedural effective regurgitant orifice area (EROA) to 
      LV end-diastolic volume (LVEDV) was retrospectively assessed in patients 
      undergoing TMVr for severe SMR between 2008 and 2019 from the EuroSMR registry. A 
      recently proposed SMR proportionality scheme was adapted to stratify patients 
      according to EROA/LVEDV ratio in 3 groups: MR-dominant (MD), MR-LV-co-dominant 
      (MLCD), and LV-dominant (LD). All-cause mortality was assessed as a primary 
      outcome, secondary heart failure (HF) outcomes included hospitalization for HF 
      (HHF), New York Heart Association (NYHA) functional class, N-terminal pro-B-type 
      natriuretic peptide (NT-proBNP), 6-min-walk distance, quality of life and MR 
      grade. RESULTS: A total of 1,016 patients with an EROA/LVEDV ratio were followed 
      for 22 months after TMVr. MR was reduced to grade </=2+ in 92%, 96%, and 94% of 
      patients (for MD, MLCD, and LD, respectively; p = 0.18). After adjustment for 
      covariates including age, sex, diabetes, kidney function, body surface area, LV 
      ejection fraction, and procedural MR reduction (grade </=2+), adjusted rates of 
      2-year mortality in MD patients did not differ from those for MLCD patients (17% 
      vs. 18%, respectively), whereas it was higher in LD patients (23%; p = 0.02 for 
      comparison vs. MD+MLCD). The adjusted first HHF rate differed between groups (44% 
      in MD, 56% in MLCD, 29% in LD; p = 0.01) as did the adjusted time for first death 
      or HHF rate (66% in MD, 82% in MLCD, 68% in LD; p = 0.02). Improvement of NYHA 
      functional class was seen in all groups (p < 0.001). Values for 6-min-walk 
      distances, quality of life and NT-proBNP improved in most patients. CONCLUSIONS: 
      MD and MLCD patients had a comparable, adjusted 2-year mortality rate after TMVr 
      which was slightly better than that of LD patients. Patients treated with TMVr 
      had symptomatic improvement regardless of EROA/LVEDV ratio.
CI  - Copyright (c) 2021 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Orban, Mathias
AU  - Orban M
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany; Munich Heart Alliance, Partner Site German Center for Cardiovascular 
      Disease, Munich, Germany.
FAU - Karam, Nicole
AU  - Karam N
AD  - Department of Cardiology, European Hospital Georges Pompidou and Paris 
      Cardiovascular Research Center, INSERM U970, Paris, France.
FAU - Lubos, Edith
AU  - Lubos E
AD  - UKE Hamburg, Klinik und Poliklinik fur Allgemeine und Interventionelle 
      Kardiologie, Hamburg, Germany.
FAU - Kalbacher, Daniel
AU  - Kalbacher D
AD  - UKE Hamburg, Klinik und Poliklinik fur Allgemeine und Interventionelle 
      Kardiologie, Hamburg, Germany.
FAU - Braun, Daniel
AU  - Braun D
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany.
FAU - Deseive, Simon
AU  - Deseive S
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany.
FAU - Neuss, Michael
AU  - Neuss M
AD  - Herzzentrum Brandenburg, Medizinische Hochschule Brandenburg Theodor Fontane, 
      Bernau, Germany.
FAU - Butter, Christian
AU  - Butter C
AD  - Herzzentrum Brandenburg, Medizinische Hochschule Brandenburg Theodor Fontane, 
      Bernau, Germany.
FAU - Praz, Fabien
AU  - Praz F
AD  - Universitatsklinik fur Kardiologie, Inselspital Bern, Switzerland.
FAU - Kassar, Mohammad
AU  - Kassar M
AD  - Universitatsklinik fur Kardiologie, Inselspital Bern, Switzerland.
FAU - Petrescu, Aniela
AU  - Petrescu A
AD  - Zentrum fur Kardiologie, Johannes Gutenberg-Universitat, Mainz, Germany.
FAU - Pfister, Roman
AU  - Pfister R
AD  - Department III of Internal Medicine, Heart Center, University of Cologne, 
      Cologne, Germany.
FAU - Iliadis, Christos
AU  - Iliadis C
AD  - Department III of Internal Medicine, Heart Center, University of Cologne, 
      Cologne, Germany.
FAU - Unterhuber, Matthias
AU  - Unterhuber M
AD  - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, 
      Germany.
FAU - Lurz, Philipp
AU  - Lurz P
AD  - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, 
      Germany.
FAU - Thiele, Holger
AU  - Thiele H
AD  - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, 
      Germany.
FAU - Baldus, Stephan
AU  - Baldus S
AD  - Department III of Internal Medicine, Heart Center, University of Cologne, 
      Cologne, Germany.
FAU - von Bardeleben, Ralph Stephan
AU  - von Bardeleben RS
AD  - Zentrum fur Kardiologie, Johannes Gutenberg-Universitat, Mainz, Germany.
FAU - Blankenberg, Stefan
AU  - Blankenberg S
AD  - UKE Hamburg, Klinik und Poliklinik fur Allgemeine und Interventionelle 
      Kardiologie, Hamburg, Germany.
FAU - Massberg, Steffen
AU  - Massberg S
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany; Munich Heart Alliance, Partner Site German Center for Cardiovascular 
      Disease, Munich, Germany.
FAU - Windecker, Stephan
AU  - Windecker S
AD  - Universitatsklinik fur Kardiologie, Inselspital Bern, Switzerland.
FAU - Hausleiter, Jorg
AU  - Hausleiter J
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany; Munich Heart Alliance, Partner Site German Center for Cardiovascular 
      Disease, Munich, Germany. Electronic address: joerg.hausleiter@med.lmu.de.
CN  - EuroSMR Investigators
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200826
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
SB  - IM
CIN - JACC Cardiovasc Imaging. 2021 Apr;14(4):726-729. PMID: 32861653
MH  - Humans
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - *Mitral Valve Insufficiency/diagnostic imaging/surgery
MH  - Predictive Value of Tests
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MR proportionality
OT  - echocardiography
OT  - heart failure
OT  - secondary mitral regurgitation
OT  - transcatheter mitral valve repair
COIS- Funding Support and Author Disclosures This work was supported by Klinikum der 
      Universitat Munchen. Dr. Hausleiter has received speaker honoraria from Abbott 
      Vascular and Edwards Lifesciences. Dr. Karam has received consultant fees from 
      Abbott Vascular. Dr. Pfister has received financial support for attending 
      symposia by Abbot Vascular. Dr. Lurz is a consultant to Abbott Vascular, Edwards 
      Lifesciences, and Medtronic. Dr. Windecker has received research and educational 
      grants to his institution from Abbott, Amgen, Bayer, Bristol-Myers Squibb, 
      Biotronik, Boston Scientific, CSL Behring, Medtronic, Edwards Lifesciences, 
      Polares, and Sinomed. All other authors have reported that they have no 
      relationships relevant to the contents of this paper to disclose.
FIR - Orban, Mathias
IR  - Orban M
FIR - Stolz, Lukas
IR  - Stolz L
FIR - Orban, Martin
IR  - Orban M
FIR - Braun, Daniel
IR  - Braun D
FIR - Nabauer, Michael
IR  - Nabauer M
FIR - Deseive, Simon
IR  - Deseive S
FIR - Massberg, Steffen
IR  - Massberg S
FIR - Hausleiter, Jorg
IR  - Hausleiter J
FIR - Karam, Nicole
IR  - Karam N
FIR - Puscas, Tania
IR  - Puscas T
FIR - Tence, Noemie
IR  - Tence N
FIR - Latremouille, Christian
IR  - Latremouille C
FIR - Lubos, Edith
IR  - Lubos E
FIR - Kalbacher, Daniel
IR  - Kalbacher D
FIR - Westermann, Dirk
IR  - Westermann D
FIR - Schofer, Niklas
IR  - Schofer N
FIR - Ludwig, Sebastian
IR  - Ludwig S
FIR - Blankenberg, Stefan
IR  - Blankenberg S
FIR - Neuss, Michael
IR  - Neuss M
FIR - Bannehr, Marvin
IR  - Bannehr M
FIR - Kucken, Tanja
IR  - Kucken T
FIR - Edlinger, Christoph
IR  - Edlinger C
FIR - Hahnel, Valentin
IR  - Hahnel V
FIR - Butter, Christian
IR  - Butter C
FIR - Praz, Fabien
IR  - Praz F
FIR - Kassar, Mohammad
IR  - Kassar M
FIR - Brugger, Nicolas
IR  - Brugger N
FIR - Pilgrim, Thomas
IR  - Pilgrim T
FIR - Winkel, Mirjam G
IR  - Winkel MG
FIR - Windecker, Stephan
IR  - Windecker S
FIR - Petrescu, Aniela
IR  - Petrescu A
FIR - von Bardeleben, Stephan
IR  - von Bardeleben S
FIR - Pfister, Roman
IR  - Pfister R
FIR - Iliadis, Christos
IR  - Iliadis C
FIR - Korber, Maria
IR  - Korber M
FIR - Mauri, Viktor
IR  - Mauri V
FIR - Wosten, Monique
IR  - Wosten M
FIR - Stephan Baldus, Clemens Metze
IR  - Stephan Baldus CM
FIR - Unterhuber, Matthias
IR  - Unterhuber M
FIR - Lurz, Philipp
IR  - Lurz P
FIR - Noack, Thilo
IR  - Noack T
FIR - Borger, Michael
IR  - Borger M
FIR - Blazek, Stephan
IR  - Blazek S
FIR - Desch, Steffen
IR  - Desch S
FIR - Thiele, Holger
IR  - Thiele H
EDAT- 2020/08/31 06:00
MHDA- 2021/08/28 06:00
CRDT- 2020/08/31 06:00
PHST- 2020/04/13 00:00 [received]
PHST- 2020/05/07 00:00 [revised]
PHST- 2020/05/19 00:00 [accepted]
PHST- 2020/08/31 06:00 [pubmed]
PHST- 2021/08/28 06:00 [medline]
PHST- 2020/08/31 06:00 [entrez]
AID - S1936-878X(20)30620-3 [pii]
AID - 10.1016/j.jcmg.2020.05.042 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2021 Apr;14(4):715-725. doi: 10.1016/j.jcmg.2020.05.042. 
      Epub 2020 Aug 26.