PMID- 33502087
OWN - NLM
STAT- MEDLINE
DCOM- 20211011
LR  - 20211011
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 97
IP  - 6
DP  - 2021 May 1
TI  - 30-day patient reported outcomes can be predicted by change in left atrial 
      pressure and not change in transmitral gradient following MitraClip.
PG  - 1244-1249
LID - 10.1002/ccd.29477 [doi]
AB  - BACKGROUND: Change in left atrial pressure (LAP) has been shown to be associated 
      with symptom improvement post-MitraClip; however, the association between acute 
      procedural changes in transmitral diastolic mean gradient (MG) compared to LAP 
      and symptom improvement is not well established. METHODS: 164 consecutive 
      patients undergoing MitraClip at Mayo Clinic between June 2014 and May 2018 were 
      included. Preclip and postclip MG and LAP were recorded. Baseline demographics, 
      clinical, and echocardiographic outcomes, including 30-day New York Heart 
      Association (NYHA) functional status were obtained from patient charts. RESULTS: 
      Median age was 81.5 years (IQR: 76.3, 87), 34% were female and 94.5% had NYHA 
      class III and IV functional status at baseline. At baseline, median MG was 4 mmHg 
      (IQR: 3, 5) and LAP was 19 mmHg (IQR: 16, 23.5). Following MitraClip deployment, 
      the median MG was 4 mmHg (IQR: 3, 6) and the median LAP was 17 mmHg (IQR: 14, 
      21), 69.5% of patients had less than moderate MR. There was no statistically 
      significant association between change in MG and NYHA functional class at 30 days 
      (OR = 0.95, 95% CI: 0.76-1.20). However, a reduction in LAP following MitraClip 
      deployment was significantly associated with improvement in NYHA functional 
      status at 30 days following adjustments for age and sex (aOR 3.36, 95% CI: 
      1.34-8.65). There was no significant correlation between change in mean LAP and 
      change in MG (p = .98). CONCLUSION: Unlike change in left atrial pressure, change 
      in MG post-MitraClip was not associated with patient reported outcomes at 30 days 
      and did not correlate with change in left atrial pressure. Long-term follow up is 
      needed to evaluate the impact of LA pressure on symptoms.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Pierre, Keniel
AU  - Pierre K
AUID- ORCID: 0000-0002-5409-1708
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Adedinsewo, Demilade A
AU  - Adedinsewo DA
AUID- ORCID: 0000-0002-8629-2029
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Al-Hijji, Mohammed
AU  - Al-Hijji M
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Miranda, William R
AU  - Miranda WR
AUID- ORCID: 0000-0001-8864-8474
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Alkhouli, Mohamad
AU  - Alkhouli M
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Eleid, Mackram F
AU  - Eleid MF
AUID- ORCID: 0000-0001-6082-5379
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Guerrero, Mayra
AU  - Guerrero M
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Pollak, Peter M
AU  - Pollak PM
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Rihal, Charanjit S
AU  - Rihal CS
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
FAU - El Sabbagh, Abdallah
AU  - El Sabbagh A
AUID- ORCID: 0000-0003-3250-1312
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.
LA  - eng
PT  - Journal Article
DEP - 20210127
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
CIN - Catheter Cardiovasc Interv. 2021 May 1;97(6):1250-1251. PMID: 33974748
MH  - Aged, 80 and over
MH  - *Atrial Pressure
MH  - Cardiac Catheterization/adverse effects
MH  - Female
MH  - Humans
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - *Mitral Valve Insufficiency/diagnostic imaging/surgery
MH  - Patient Reported Outcome Measures
MH  - Treatment Outcome
EDAT- 2021/01/28 06:00
MHDA- 2021/10/12 06:00
CRDT- 2021/01/27 08:39
PHST- 2020/11/27 00:00 [revised]
PHST- 2020/09/21 00:00 [received]
PHST- 2020/12/13 00:00 [accepted]
PHST- 2021/01/28 06:00 [pubmed]
PHST- 2021/10/12 06:00 [medline]
PHST- 2021/01/27 08:39 [entrez]
AID - 10.1002/ccd.29477 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2021 May 1;97(6):1244-1249. doi: 10.1002/ccd.29477. 
      Epub 2021 Jan 27.