PMID- 35550821
OWN - NLM
STAT- MEDLINE
DCOM- 20220615
LR  - 20220629
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 175
DP  - 2022 Jul 15
TI  - Meta-Analysis of Relation Between Left Ventricular Dysfunction and Outcomes After 
      Transcatheter Mitral Edge-to-Edge Repair.
PG  - 88-96
LID - S0002-9149(22)00406-4 [pii]
LID - 10.1016/j.amjcard.2022.03.059 [doi]
AB  - Randomized controlled trials (RCTs) and observational studies provided 
      conflicting results regarding the role of left ventricular (LV) function on 
      outcomes after transcatheter edge-to-edge repair (TEER). The study aimed to 
      provide a comprehensive assessment of the interplay between severe LV dysfunction 
      and TEER outcomes. Multiple electronic databases, including PubMed, EMBASE, 
      Scopus, Web of Science, and CENTRAL, were searched to identify studies on TEER 
      for secondary mitral regurgitation reporting outcomes stratified for LV ejection 
      fraction <30% and >/=30%. The prespecified primary end points were the composite of 
      all-cause death or heart failure (HF) hospitalization and New York Heart 
      Association (NYHA) class III/IV. Odds ratios (ORs) and 95% confidence intervals 
      (CIs) were estimated by random-effects models. Multiple sensitivity analyses 
      accounting for baseline characteristics and study design were applied. A total of 
      6 studies (1,957 patients) with 1 year or 2 years of follow-up were available. 
      Severe LV dysfunction was associated with an increased risk of death or HF 
      hospitalization (OR 1.71, 95% CI 1.14 to 2.57). Conversely, comparable rates of 
      NYHA class III/IV (OR 1.06, 95% CI 0.82 to 1.38) or secondary end points 
      (reinterventions, recurrence of significant secondary mitral regurgitation) were 
      found regardless of the baseline LV function. Subgroup meta-analysis found no 
      difference in the composite primary end point between patients with LV ejection 
      fraction <30% and >/=30% enrolled in RCTs. In conclusion, TEER seems to be 
      associated with higher mortality or HF hospitalization rates in patients with 
      severe LV dysfunction. However, RCTs found no differences between groups. No 
      impact of LV function was found on the risk of NYHA class III/IV or other 
      clinical outcomes.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Scotti, Andrea
AU  - Scotti A
AD  - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical 
      Center, Albert Einstein College of Medicine, Bronx, New York.
FAU - Massussi, Mauro
AU  - Massussi M
AD  - Division of Cardiology, "Spedali Civili" University Hospital, Brescia, Italy.
FAU - Latib, Azeem
AU  - Latib A
AD  - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical 
      Center, Albert Einstein College of Medicine, Bronx, New York.
FAU - Munafo, Andrea
AU  - Munafo A
AD  - Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
FAU - Colombo, Antonio
AU  - Colombo A
AD  - Humanitas Clinical and Research Center Istituto di Ricovero e Cura a Carattere 
      Scientifico (IRCCS) - Rozzano, Milan, Italy.
FAU - Taramasso, Maurizio
AU  - Taramasso M
AD  - Division of Cardiothoracic Surgery, Arzt bei Herzzentrum Hirslanden Zurich, 
      Zurich, Switzerland.
FAU - Margonato, Alberto
AU  - Margonato A
AD  - Division of Cardiology.
FAU - Maisano, Francesco
AU  - Maisano F
AD  - Division of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy.
FAU - Godino, Cosmo
AU  - Godino C
AD  - Division of Cardiology. Electronic address: godino.cosmo@hsr.it.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20220509
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Humans
MH  - *Mitral Valve Insufficiency/epidemiology/etiology/surgery
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - *Ventricular Dysfunction, Left/complications/epidemiology
MH  - Ventricular Function, Left
COIS- Disclosures The authors have no conflicts of interest to declare.
EDAT- 2022/05/14 06:00
MHDA- 2022/06/16 06:00
CRDT- 2022/05/13 12:57
PHST- 2022/02/01 00:00 [received]
PHST- 2022/03/19 00:00 [revised]
PHST- 2022/03/23 00:00 [accepted]
PHST- 2022/05/14 06:00 [pubmed]
PHST- 2022/06/16 06:00 [medline]
PHST- 2022/05/13 12:57 [entrez]
AID - S0002-9149(22)00406-4 [pii]
AID - 10.1016/j.amjcard.2022.03.059 [doi]
PST - ppublish
SO  - Am J Cardiol. 2022 Jul 15;175:88-96. doi: 10.1016/j.amjcard.2022.03.059. Epub 
      2022 May 9.