PMID- 35842361
OWN - NLM
STAT- MEDLINE
DCOM- 20221114
LR  - 20240205
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 15
IP  - 11
DP  - 2022 Nov
TI  - Transcatheter Mitral Valve Repair in Patients With Atrial Functional 
      Mitral Regurgitation.
PG  - 1843-1851
LID - S1936-878X(22)00343-6 [pii]
LID - 10.1016/j.jcmg.2022.05.009 [doi]
AB  - BACKGROUND: Among patients with severe functional mitral regurgitation (FMR), 
      atrial functional mitral regurgitation (aFMR) represents an underrecognized 
      entity. Data regarding outcomes after mitral valve transcatheter edge-to-edge 
      repair (M-TEER) in aFMR remain scarce. OBJECTIVES: The objective of this study 
      was to analyze the outcome of aFMR patients undergoing M-TEER. METHODS: Using 
      patients from the international EuroSMR (European Registry of Transcatheter 
      Repair for Secondary Mitral Regurgitation) registry undergoing M-TEER for FMR, 
      the authors analyzed baseline characteristics and 2-year outcomes in aFMR in 
      comparison to non-aFMR and ventricular FMR. Additionally, the impact of right 
      ventricular dysfunction (RVD) (defined as right ventricular to pulmonary artery 
      uncoupling) on outcome after M-TEER was assessed. RESULTS: Among 1,608 FMR 
      patients treated by M-TEER, 126 (7.8%) were categorized as aFMR. All 126 aFMR 
      patients had preserved left ventricular function without regional wall motion 
      abnormalities, left arterial dilatation and Carpentier leaflet motion type I. 
      Procedural success (defined as mitral regurgitation </=2+ at discharge) was 87.2% 
      (P < 0.001) and New York Heart Association (NYHA) functional class significantly 
      improved during follow-up (NYHA functional class III/IV: 86.5% at baseline to 
      36.6% at follow-up; P < 0.001). The estimated 2-year survival rate in aFMR 
      patients was 70.4%. Two-year survival did not differ significantly between aFMR, 
      non-aFMR, and ventricular FMR. Besides NYHA functional class IV, RVD was 
      identified as a strong independent predictor for 2-year survival (HR: 2.82 
      [95% CI: 1.24-6.45]; P = 0.014). CONCLUSIONS: aFMR is a frequent cause of FMR and 
      can be effectively treated with M-TEER to improve symptoms at follow-up. Advanced 
      heart failure symptoms and RVD were identified as important risk factors for 
      survival in aFMR patients.
CI  - Copyright (c) 2022 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Doldi, Philipp
AU  - Doldi P
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany; Munich Heart Alliance, Partner Site German Center for Cardiovascular 
      Disease (DZHK), Munich, Germany.
FAU - Stolz, Lukas
AU  - Stolz L
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany.
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 (DZHK), Munich, Germany.
FAU - Karam, Nicole
AU  - Karam N
AD  - Paris University, PARCC, INSERM, F-75015, European Hospital Georges Pompidou, 
      Paris, France.
FAU - Praz, Fabien
AU  - Praz F
AD  - Universitatsklinik fur Kardiologie, Bern University Hospital, Inselspital Bern, 
      Switzerland.
FAU - Kalbacher, Daniel
AU  - Kalbacher D
AD  - Universitares Herz- und Gefasszentrum Hamburg, Klinik fur Kardiologie, Germany; 
      German Center for Cardiovascular Research (DZHK), Partner Site 
      Hamburg/Lubeck/Kiel, Germany.
FAU - Lubos, Edith
AU  - Lubos E
AD  - Universitares Herz- und Gefasszentrum Hamburg, Klinik fur Kardiologie, Germany; 
      German Center for Cardiovascular Research (DZHK), Partner Site 
      Hamburg/Lubeck/Kiel, Germany.
FAU - Braun, Daniel
AU  - Braun D
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany; Munich Heart Alliance, Partner Site German Center for Cardiovascular 
      Disease (DZHK), Munich, Germany.
FAU - Adamo, Marianna
AU  - Adamo M
AD  - Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili and 
      Department of Medical and Surgical Specialties, Radiological Sciences and Public 
      Health, University of Brescia, Brescia, Italy.
FAU - Giannini, Cristina
AU  - Giannini C
AD  - Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, 
      University of Pisa, Pisa, Italy.
FAU - Melica, Bruno
AU  - Melica B
AD  - Cardiology Department, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal.
FAU - Nabauer, Michael
AU  - Nabauer M
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany.
FAU - Higuchi, Satoshi
AU  - Higuchi S
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany.
FAU - Wild, Mirjam
AU  - Wild M
AD  - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, 
      Germany.
FAU - Neuss, Michael
AU  - Neuss M
AD  - Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili and 
      Department of Medical and Surgical Specialties, Radiological Sciences and Public 
      Health, University of Brescia, Brescia, Italy.
FAU - Butter, Christian
AU  - Butter C
AD  - Herzzentrum Brandenburg, Medizinische Hochschule Brandenburg Theodor Fontane, 
      Bernau, Germany.
FAU - Kassar, Mohammad
AU  - Kassar M
AD  - Universitatsklinik fur Kardiologie, Bern University Hospital, 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 - 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 - Schofer, Niklas
AU  - Schofer N
AD  - Universitares Herz- und Gefasszentrum Hamburg, Klinik fur Kardiologie, Germany.
FAU - Hagl, Christian
AU  - Hagl C
AD  - Herzchirurgische Klinik und Poliklinik, Klinikum der Universitat Munchen, Munich, 
      Germany.
FAU - Petronio, Anna Sonia
AU  - Petronio AS
AD  - Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, 
      University of Pisa, Pisa, Italy.
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 (DZHK), Munich, Germany.
FAU - Windecker, Stephan
AU  - Windecker S
AD  - Universitatsklinik fur Kardiologie, Bern University Hospital, Inselspital Bern, 
      Switzerland.
FAU - Lurz, Philipp
AU  - Lurz P
AD  - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, 
      Germany.
FAU - Metra, Marco
AU  - Metra M
AD  - Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili and 
      Department of Medical and Surgical Specialties, Radiological Sciences and Public 
      Health, University of Brescia, Brescia, Italy.
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 (DZHK), Munich, Germany. Electronic address: 
      joerg.hausleiter@med.uni-muenchen.de.
LA  - eng
PT  - Journal Article
DEP - 20220713
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
SB  - IM
CIN - J Cardiothorac Vasc Anesth. 2023 Jan;37(1):1-2. PMID: 36273945
CIN - JACC Cardiovasc Imaging. 2022 Nov;15(11):1852-1855. PMID: 36357128
CIN - JACC Cardiovasc Imaging. 2023 Mar;16(3):432-433. PMID: 36889856
MH  - Humans
MH  - *Mitral Valve Insufficiency/diagnostic imaging/surgery/etiology
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - Predictive Value of Tests
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Ventricular Function, Left
MH  - *Ventricular Dysfunction, Right
MH  - Treatment Outcome
MH  - *Heart Valve Prosthesis Implantation/adverse effects
OTO - NOTNLM
OT  - atrial functional mitral valve regurgitation
OT  - congestive heart failure
OT  - mitral valve transcatheter edge-to-edge valve repair
OT  - right ventricular dysfunction
OT  - secondary mitral valve regurgitation
COIS- Funding Support and Author Disclosures Dr Stolz has received travel expenses from 
      Edwards LifeSciences. Dr Orban has received speaker honoraria from Abbott 
      Vascular and Abbot Medical; and has received speaker fees from TOMTEC Imaging 
      Systems. Dr Karam has received speaker honoraria from Abbott Vascular; and has 
      received consultant fees from Abbott Medical. Dr Praz has received travel 
      expenses from Abbott Medical and Edwards LifeSciences. Dr Kalbacher has received 
      speaker honoraria and travel expenses from Abbott Medical; and has received 
      speaker honoraria, travel expenses, and proctor fees from Edwards LifeSciences. 
      Dr Lubos has received speaker honoraria and research grants from Abbott Medical. 
      Dr Braun has received speaker honoraria from Abbott Vascular. Dr Melica has 
      received proctor fees from Abbott Medical. Dr Nabauer has received speaker 
      honoraria from Abbott Vascular. Dr Higuchi has received lecture fees from 
      Medtronic Japan, Daiichi Sankyo, and Ono Pharmaceutical Company. Dr Pfister has 
      received speaker honoraria and travel expenses from Abbott Medical. Dr Iliadis 
      has received consultant fees and travel expenses from Abbott Medical; and has 
      received consultant fees from Edwards LifeSciences. Dr Baldus has received 
      speaker honoraria from Abbott Medical and Edwards LifeSciences; and has received 
      research grants from Abbott Medical. Dr Schofer has received travel expenses from 
      Abbott Medical and Edwards LifeSciences. Dr Windecker has received research 
      and educational grants to the institution from Abbott, Amgen, AstraZeneca, BMS, 
      Bayer, Biotronik, Boston Scientific, Cardinal Health, CardioValve, CSL Behring, 
      Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Johnson & Johnson, 
      Medicure, Medtronic, Novartis, Polares, OrPha Suisse, Pfizer, Regeneron, 
      Sanofi-Aventis, Sinomed, and Terumo, V-Wave; serves as unpaid advisory board 
      member and/or unpaid member of the steering/executive group of trials funded by 
      Abbott, Abiomed, Amgen, AstraZeneca, BMS, Boston Scientific, Biotronik, 
      Cardiovalve, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, 
      Sinomed, V-Wave and Xeltis, but has not received personal payments by 
      pharmaceutical companies or device manufacturers; and is a member of the 
      steering/executive committee group of several investigator-initiated trials that 
      receive funding by industry without impact on his personal remuneration. Dr Lurz 
      has received speaker honoraria and consultant fees from Abbott Medical. Dr Metra 
      has received consultant fees from Abbott Medical; and has received speaker 
      honoraria from Edwards LifeSciences. Dr Hausleiter has received speaker honoraria 
      from and serves as consultant for Abbott Vascular and Edwards Lifesciences. All 
      other authors have reported that they have no relationships relevant to the 
      contents of this paper to disclose.
EDAT- 2022/07/17 06:00
MHDA- 2022/11/15 06:00
CRDT- 2022/07/16 22:04
PHST- 2021/12/27 00:00 [received]
PHST- 2022/05/02 00:00 [revised]
PHST- 2022/05/19 00:00 [accepted]
PHST- 2022/07/17 06:00 [pubmed]
PHST- 2022/11/15 06:00 [medline]
PHST- 2022/07/16 22:04 [entrez]
AID - S1936-878X(22)00343-6 [pii]
AID - 10.1016/j.jcmg.2022.05.009 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2022 Nov;15(11):1843-1851. doi: 
      10.1016/j.jcmg.2022.05.009. Epub 2022 Jul 13.