PMID- 33939295
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20240403
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 8
IP  - 4
DP  - 2021 Aug
TI  - Long-term clinical and haemodynamic results after transcatheter annuloplasty for 
      secondary mitral regurgitation.
PG  - 2448-2457
LID - 10.1002/ehf2.13383 [doi]
AB  - AIMS: The study sought to investigate the long-term outcome after transcatheter 
      mitral valve annuloplasty for secondary mitral regurgitation (MR). METHODS AND 
      RESULTS: Consecutive patients with symptomatic secondary MR undergoing 
      transcatheter mitral valve annuloplasty with the Carillon device at Leipzig 
      University Hospital between 2012 and 2018 were studied prospectively. Left 
      ventricular (LV) function and MR severity were quantified by standardized 
      echocardiography. 33 patients were included. Mean age was 75 +/- 10 years, and 20 
      patients were women. A Society of Thoracic Surgeons score of 8.1 +/- 7.2% indicated 
      high-risk status. In 24 patients, MR resulted from LV remodelling and 
      dysfunction, eight suffered from left atrial dilatation, and one patient had MR 
      due to combined primary and secondary aetiology. LV ejection fraction at baseline 
      was (median) 38% [inter-quartile range (IQR) 30-49%]. During the mean follow-up 
      time of 45 +/- 20 months, 17 patients died, two patients withdraw consent, and four 
      patients were lost. Of the remaining patients, four were hospitalized for 
      decompensated heart failure. Two of these patients underwent additional 
      transcatheter edge-to-edge mitral valve repair. At follow-up, New York Heart 
      Association (NYHA) functional class improved from 95% in Class III/IV at baseline 
      to 70% in Class I/II with no patients in NYHA Class IV (P < 0.0001). Mitral 
      regurgitant volume was reduced from 27 mL (IQR 25-42 mL) to 8 mL (IQR 3-17 mL) 
      (P = 0.018) and regurgitant fraction from 42% (IQR 34-54%) to 11% (IQR 8-24%) 
      (P = 0.014). LV end-diastolic volume index [92 mL/m(2) (IQR 74-107 mL/m(2) ) vs. 
      67 mL/m(2) (IQR 46-101 mL/m(2) ), P = 0.065] and end-systolic volume index 
      [50 mL/m(2) (IQR 44-69 mL/m(2) ) vs. 32 mL/m(2) (IQR 20-53 mL/m(2) ), P = 0.037] 
      decreased. Total stroke volume remained unchanged [38 mL/m(2) (IQR 33-43 mL/m(2) 
      ) vs. 33 mL/m(2) (IQR 26-44 mL/m(2) ), P = 0.695], while LV ejection fraction 
      increased [43% (IQR 35-49%) vs. 54% (IQR 46-57%), P = 0.014]. Forward stroke 
      volume, heart rate, and forward cardiac output were not significantly altered. 
      CONCLUSIONS: Among high-risk patients undergoing transcatheter mitral valve 
      annuloplasty for symptomatic secondary MR, mortality was ~50% at 4 years. In the 
      surviving patients, reduced MR severity was associated with reduced NYHA 
      functional class, reverse LV remodelling, and improved LV function.
CI  - (c) 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of European Society of Cardiology.
FAU - Lavall, Daniel
AU  - Lavall D
AD  - Klinik und Poliklinik fur Kardiologie, Universitatsklinikum Leipzig, Liebigstrasse 
      20, Leipzig, 04103, Germany.
FAU - Bruns, Julius
AU  - Bruns J
AD  - Klinik und Poliklinik fur Kardiologie, Universitatsklinikum Leipzig, Liebigstrasse 
      20, Leipzig, 04103, Germany.
FAU - Stegmann, Tina
AU  - Stegmann T
AD  - Klinik und Poliklinik fur Kardiologie, Universitatsklinikum Leipzig, Liebigstrasse 
      20, Leipzig, 04103, Germany.
FAU - Hagendorff, Andreas
AU  - Hagendorff A
AD  - Klinik und Poliklinik fur Kardiologie, Universitatsklinikum Leipzig, Liebigstrasse 
      20, Leipzig, 04103, Germany.
FAU - Stobe, Stephan
AU  - Stobe S
AD  - Klinik und Poliklinik fur Kardiologie, Universitatsklinikum Leipzig, Liebigstrasse 
      20, Leipzig, 04103, Germany.
FAU - Laufs, Ulrich
AU  - Laufs U
AD  - Klinik und Poliklinik fur Kardiologie, Universitatsklinikum Leipzig, Liebigstrasse 
      20, Leipzig, 04103, Germany.
LA  - eng
PT  - Journal Article
DEP - 20210503
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - *Mitral Valve Annuloplasty
MH  - *Mitral Valve Insufficiency/diagnosis/etiology/surgery
MH  - Treatment Outcome
PMC - PMC8318490
OTO - NOTNLM
OT  - Annuloplasty
OT  - Heart failure
OT  - Mitral valve repair
OT  - Secondary mitral regurgitation
COIS- D.L. received speaker honoraria from Cardiac Dimensions. J.B., T.S., S.S., and 
      U.L. declared no conflicts of interest. A.H. received speaker honoraria from 
      Cardiac Dimensions.
EDAT- 2021/05/04 06:00
MHDA- 2021/10/29 06:00
PMCR- 2021/05/03
CRDT- 2021/05/03 12:53
PHST- 2021/03/25 00:00 [revised]
PHST- 2021/01/08 00:00 [received]
PHST- 2021/04/12 00:00 [accepted]
PHST- 2021/05/04 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2021/05/03 12:53 [entrez]
PHST- 2021/05/03 00:00 [pmc-release]
AID - EHF213383 [pii]
AID - 10.1002/ehf2.13383 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2021 Aug;8(4):2448-2457. doi: 10.1002/ehf2.13383. Epub 2021 May 
      3.