PMID- 33811553
OWN - NLM
STAT- MEDLINE
DCOM- 20220208
LR  - 20220208
IS  - 1615-2573 (Electronic)
IS  - 0910-8327 (Print)
IS  - 0910-8327 (Linking)
VI  - 36
IP  - 10
DP  - 2021 Oct
TI  - Predictors of functional mitral regurgitation recurrence after percutaneous 
      mitral valve repair.
PG  - 1574-1583
LID - 10.1007/s00380-021-01828-9 [doi]
AB  - We aimed to identify predictors of mitral regurgitation recurrence (MR) after 
      percutaneous mitral valve repair (PMVR) in patients with functional mitral 
      regurgitation (FMR). Patients with FMR were enrolled who underwent PMVR using the 
      MitraClip((R)) device. Procedural success was defined as reduction of MR of at 
      least one grade to MR grade </= 2 + assessed at discharge. Recurrence of MR was 
      defined as MR grade 3 + or worse at one year after initially successful PMVR. A 
      total of 306 patients with FMR underwent PMVR procedure. In 279 out of 306 
      patients (91.2%), PMVR was successfully performed with MR grade </= 2 + at 
      discharge. In 11.4% of these patients, MR recurrence of initial successful PMVR 
      after 1 year was observed. Recurrence of MR was associated with a higher rate of 
      heart failure rehospitalization during the 12 months follow-up (52.0% vs. 30.3%; 
      p = 0.029), and less improvement in New York Heart Association (NYHA) functional 
      class [68% vs. 19% of the patients presenting with NYHA functional class III or 
      IV one year after PMVR when compared to patients without recurrence (p = 0.001)]. 
      Patients with MR recurrence were characterized by a higher left ventricular 
      sphericity index 0.69 [Interquartile range (IQR) 0.64, 0.74] vs. 0.65 (IQR 0.58, 
      0.70), p = 0.003, a larger left atrium volume [118 (IQR 96, 143) ml vs. 102 (IQR 
      84, 123) ml, p = 0.019], a larger tenting height 10 (IQR 9, 13) mm vs. 8 (IQR 7, 
      11) mm (p = 0.047), and a larger mitral valve annulus [41 (IQR 38, 43) mm vs. 39 
      (IQR 36, 40) mm, p = 0.015] when compared to patients with durable optimal 
      long-term results. In a multivariate regression model, the left ventricular 
      sphericity index [Odds Ratio (OR) 1.120, 95% Confidence Interval (CI) 
      1.039-1.413, p = 0.003)], tenting height (OR 1.207, 95% CI 1.031-1.413, 
      p = 0.019), and left atrium enlargement (OR 1.018, 95% CI 1.000-1.038, p = 0.047) 
      were predictors for MR recurrence after 1 year. In patients with FMR, baseline 
      parameters of advanced heart failure such as spherical ventricle, tenting height 
      and a large left atrium might indicate risk of recurrent MR one year after PMVR.
CI  - (c) 2021. The Author(s).
FAU - Hellhammer, Katharina
AU  - Hellhammer K
AD  - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine University, University Hospital Dusseldorf, Moorenstrasse 5, 
      40225, Dusseldorf, Germany.
FAU - Haurand, Jean M
AU  - Haurand JM
AD  - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine University, University Hospital Dusseldorf, Moorenstrasse 5, 
      40225, Dusseldorf, Germany.
FAU - Spieker, Maximilian
AU  - Spieker M
AD  - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine University, University Hospital Dusseldorf, Moorenstrasse 5, 
      40225, Dusseldorf, Germany.
FAU - Luedike, Peter
AU  - Luedike P
AD  - West German Heart and Vascular Center Essen, Department of Cardiology and 
      Vascular Medicine, University Hospital Essen, Essen, Germany.
FAU - Rassaf, Tienush
AU  - Rassaf T
AD  - West German Heart and Vascular Center Essen, Department of Cardiology and 
      Vascular Medicine, University Hospital Essen, Essen, Germany.
FAU - Zeus, Tobias
AU  - Zeus T
AD  - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine University, University Hospital Dusseldorf, Moorenstrasse 5, 
      40225, Dusseldorf, Germany.
FAU - Kelm, Malte
AU  - Kelm M
AD  - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine University, University Hospital Dusseldorf, Moorenstrasse 5, 
      40225, Dusseldorf, Germany.
AD  - Cardiovascular Research Institute, Medical Faculty, Heinrich-Heine University, 
      Dusseldorf, Germany.
FAU - Westenfeld, Ralf
AU  - Westenfeld R
AD  - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine University, University Hospital Dusseldorf, Moorenstrasse 5, 
      40225, Dusseldorf, Germany.
FAU - Horn, Patrick
AU  - Horn P
AUID- ORCID: 0000-0002-5260-1321
AD  - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, 
      Heinrich-Heine University, University Hospital Dusseldorf, Moorenstrasse 5, 
      40225, Dusseldorf, Germany. patrick.horn@med.uni-duesseldorf.de.
LA  - eng
PT  - Journal Article
DEP - 20210403
PL  - Japan
TA  - Heart Vessels
JT  - Heart and vessels
JID - 8511258
SB  - IM
MH  - Heart Failure
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - *Mitral Valve Insufficiency/diagnosis/surgery
MH  - Treatment Outcome
PMC - PMC8379112
OTO - NOTNLM
OT  - Functional mitral regurgitation
OT  - Heart failure
OT  - Percutaneous mitral valve repair
OT  - Sphericity index
COIS- Maximilian Spieker, Peter Luedike, Tobias Zeus, Ralf Westenfeld and Patrick Horn 
      have received consulting fees, travel expenses, or study honoraries from Abbott 
      Vascular GmbH. All other authors have nothing to disclose with regard to this 
      project.
EDAT- 2021/04/04 06:00
MHDA- 2022/02/09 06:00
PMCR- 2021/04/03
CRDT- 2021/04/03 12:08
PHST- 2020/11/04 00:00 [received]
PHST- 2021/03/05 00:00 [accepted]
PHST- 2021/04/04 06:00 [pubmed]
PHST- 2022/02/09 06:00 [medline]
PHST- 2021/04/03 12:08 [entrez]
PHST- 2021/04/03 00:00 [pmc-release]
AID - 10.1007/s00380-021-01828-9 [pii]
AID - 1828 [pii]
AID - 10.1007/s00380-021-01828-9 [doi]
PST - ppublish
SO  - Heart Vessels. 2021 Oct;36(10):1574-1583. doi: 10.1007/s00380-021-01828-9. Epub 
      2021 Apr 3.