PMID- 36597850
OWN - NLM
STAT- MEDLINE
DCOM- 20230331
LR  - 20230406
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 25
IP  - 3
DP  - 2023 Mar
TI  - Transcatheter edge-to-edge repair for secondary mitral regurgitation with 
      third-generation devices in heart failure patients - results from the Global 
      EXPAND Post-Market study.
PG  - 411-421
LID - 10.1002/ejhf.2770 [doi]
AB  - AIMS: Mitral valve transcatheter edge-to-edge repair is a guideline-recommended 
      treatment option for patients with secondary mitral regurgitation (SMR). The 
      purpose of this analysis was to report contemporary real-world outcomes in SMR 
      patients treated with third-generation MitraClip systems. METHODS AND RESULTS: 
      EXPAND is a prospective, multicentre, international, single-arm study with 1041 
      patients treated for mitral regurgitation (MR) with MitraClip NTR/XTR, with 
      30-day and 1-year follow-up. All echocardiograms were analysed by an independent 
      echocardiographic core lab. Study outcomes included procedural outcomes, 
      durability of MR reduction, and major adverse events including all-cause 
      mortality and heart failure hospitalizations (HFH). A subgroup of 413 symptomatic 
      patients (age 74.7 +/- 10.1 years, 58% male) with severe SMR were included. MR 
      reduction to MR </= 1+ and MR </= 2+ was achieved in 93.0% and 98.5% of patients, 
      respectively, which was sustained at 1-year follow-up. All-cause mortality was 
      17.7% at 1-year- follow-up, and the combined endpoint of all-cause mortality or 
      first HFH occurred in 34% of patients. This combined endpoint was significantly 
      less frequently observed in MR </= 1+ patients (Kaplan-Maier estimates: 29.7% vs. 
      69.6% for MR </= 1+ vs. MR  >/= 2 +; p < 0.0001). New York Heart Association (NYHA) 
      functional class improved significantly from baseline (NYHA </= II: 17%) to 1-year 
      follow-up (NYHA </= II: 78%) (p < 0.0001). While MR reduction was comparable 
      between NTR-only vs. XTR-only treated patients, less XTR clips were required for 
      achieving MR reduction. CONCLUSIONS: Under real-world conditions, optimal 
      sustained MR reduction to MR </= 1+ was achieved in a high percentage of patients 
      with third-generation MitraClip, which translated into symptomatic improvement 
      and low event rates. These results appear to be comparable with recent randomized 
      clinical trials.
CI  - (c) 2023 The Authors. European Journal of Heart Failure published by John Wiley & 
      Sons Ltd on behalf of European Society of Cardiology.
FAU - Orban, Mathias
AU  - Orban M
AUID- ORCID: 0000-0001-7846-8808
AD  - Medizinische Klinik I, Ludwig-Maximilians Universitat, Munich, Germany.
AD  - Munich Heart Alliance, Partner site German Centre for Cardiovascular Research 
      (DZHK), Munich, Germany.
FAU - Rottbauer, Wolfgang
AU  - Rottbauer W
AD  - Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
FAU - Williams, Mathew
AU  - Williams M
AD  - Heart Valve Center, New York University Langone Health, New York, NY, USA.
FAU - Mahoney, Paul
AU  - Mahoney P
AD  - Sentera Heart and Valve and Structural Disease Center, Norfolk, VA, USA.
FAU - von Bardeleben, Ralph Stephan
AU  - von Bardeleben RS
AD  - Department of Cardiology, University Medical Center of Mainz, Mainz, Germany.
FAU - Price, Matthew J
AU  - Price MJ
AD  - Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA, USA.
FAU - Grasso, Carmelo
AU  - Grasso C
AD  - Department of Cardiology, Ferrarotto Hospital, University of Catania, Catania, 
      Italy.
FAU - Lurz, Philipp
AU  - Lurz P
AD  - Department of Cardiology, Heart Center Leipzig - University Hospital, Leipzig, 
      Germany.
FAU - Zamorano, Jose L
AU  - Zamorano JL
AD  - Hospital Ramon y Cajal, Madrid, Spain.
FAU - Asch, Federico M
AU  - Asch FM
AD  - Cardiovascular Core Laboratories, MedStar Health Research Institute, Washington, 
      DC, USA.
FAU - Maisano, Francesco
AU  - Maisano F
AD  - San Raffaele University Hospital, Milan, Italy.
FAU - Kar, Saibal
AU  - Kar S
AD  - Los Robles Regional Medical Center, Thousand Oaks, CA, USA.
FAU - Hausleiter, Jorg
AU  - Hausleiter J
AD  - Medizinische Klinik I, Ludwig-Maximilians Universitat, Munich, Germany.
AD  - Munich Heart Alliance, Partner site German Centre for Cardiovascular Research 
      (DZHK), Munich, Germany.
LA  - eng
PT  - Comment
PT  - Journal Article
DEP - 20230116
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
CIN - Eur J Heart Fail. 2023 Mar;25(3):422-424. PMID: 36799514
CON - Eur J Heart Fail. 2023 Mar;25(3):399-410. PMID: 36883620
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - *Mitral Valve Insufficiency/surgery
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - *Heart Failure
MH  - *Heart Valve Prosthesis Implantation/methods
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Cardiac Catheterization
OTO - NOTNLM
OT  - Heart failure
OT  - MitraClip
OT  - Mitral regurgitation
OT  - Mitral valve transcatheter edge-to-edge repair
OT  - Secondary mitral regurgitation
OT  - Transcatheter mitral valve repair
EDAT- 2023/01/05 06:00
MHDA- 2023/03/31 06:41
CRDT- 2023/01/04 04:43
PHST- 2022/12/30 00:00 [revised]
PHST- 2022/10/05 00:00 [received]
PHST- 2023/01/03 00:00 [accepted]
PHST- 2023/03/31 06:41 [medline]
PHST- 2023/01/05 06:00 [pubmed]
PHST- 2023/01/04 04:43 [entrez]
AID - 10.1002/ejhf.2770 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2023 Mar;25(3):411-421. doi: 10.1002/ejhf.2770. Epub 2023 Jan 
      16.