Acute Reduction in Left Ventricular Function Following Transcatheter Mitral Edge‐to‐Edge Repair-Reference-Cited by-同舟云学术

Acute Reduction in Left Ventricular Function Following Transcatheter Mitral Edge‐to‐Edge Repair

Published:2023-07-04 Issue:13 Volume:12 Page:
ISSN:2047-9980
Container-title:Journal of the American Heart Association
language:en
Short-container-title:JAHA

Author:

Perl Leor¹^ORCID,Kheifets Mark¹^ORCID,Guido Ascione²^ORCID,Agricola Eustachio²^ORCID,Denti Paolo²^ORCID,Wild Mirjam Gauri³⁴^ORCID,Praz Fabien⁴^ORCID,Rubbio Antonio Popolo⁵^ORCID,Bedogni Francesco⁵,De Marco Federico⁵⁶^ORCID,Beeri Ronen⁷^ORCID,Shuvy Mony⁷⁸,Melillo Francesco²^ORCID,Montorfano Matteo²,Freixa Xavier⁹,de la Fuente Mancera Juan Carlos⁹^ORCID,Giordano Arturo¹⁰,Finizio Filippo¹⁰^ORCID,Van Mieghem Nicolas M.¹¹^ORCID,Ooms J. F. W.¹¹^ORCID,Fam Neil²¹²,O'Connor Cormac¹²^ORCID,Toggweiler Stefan¹³^ORCID,Levi Amos¹,Shapira Yaron¹,Schwartzenberg Shmuel¹^ORCID,Pidello Stefano¹⁴^ORCID,D'Ascenzo Fabrizio¹⁴^ORCID,Angelini Filippo¹⁴^ORCID,Haberman Dan¹⁵^ORCID,Crimi Gabriele¹⁶^ORCID,Porto Italo¹⁶^ORCID,Cozzi Ottavia¹⁷^ORCID,Giannini Francesco¹⁸^ORCID,Tarantini Giuseppe¹⁹^ORCID,Maisano Francesco²^ORCID,Kornowski Ran¹^ORCID,Perl Leor,Kheifets Mark,Levi Amos,Shapira Yaron,Schwartzenberg Shmuel,Kornowski Ran,Guido Ascione,Agricola Eustachio,Denti Paolo,Melillo Francesco,Montorfano Matteo,Maisano Francesco,Wild Mirjam Gauri,Praz Fabien,Rubbio Antonio Popolo,Bedogni Francesco,De Marco Federico,Beeri Ronen,Shuvy Mony,Freixa Xavier,de la Fuente Mancera Juan Carlos,Giordano Arturo,Finizio Filippo,Corcione Nicola,Van Mieghem Nicolas M.,Ooms J. F. W.,Fam Neil,O’Connor Cormac,Toggweiler Stefan,Pidello Stefano,D’Ascenzo Fabrizio,Angelini Filippo,Haberman Dan,Crimi Gabriele,Porto Italo,Cozzi Ottavia,Mangieri Antonio,Regazzoli Damiano,Giannini Francesco,Cimaglia Paolo,Flamigni Filippo,Tarantini Giuseppe,Masiero Giulia

Affiliation:

1. Division of Cardiology, Rabin Medical Center–Beilinson Hospital, Petah‐Tikva, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

2. Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital Vita‐Salute San Raffaele University Milan Italy

3. University Heart Center Freiburg/Bad Krozingen Bad Krozingen Germany

4. Department of Cardiology, Bern University Hospital University of Bern Bern, Switzerland

5. Clinical and Interventional Cardiology IRCCS Policlinico San Donato San Donato Milanese Italy

6. Centro Cardiologico Monzino IRCCS Milan Italy

7. Heart Institute, Hadassah‐Hebrew University Medical Center, Faculty of Medicine Hebrew University Jerusalem Israel

8. Jesselson Integrated Heart Centre, Shaare Zedek Medical Center and Faculty of Medicine Hebrew University Jerusalem Israel

9. Hospital Clinic of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona Barcelona Spain

10. Invasive Cardiology Unit Pineta Grande Hospital Caserta Italy

11. Department of Interventional Cardiology, Thoraxcenter Erasmus University Medical Center Rotterdam the Netherlands

12. Structural Heart Program, St. Michael’s Hospital University of Toronto Toronto, Ontario Canada

13. Heart Center Lucerne, Department of Cardiology Luzerner Kantonsspital Lucerne Switzerland

14. Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital University of Turin Turin, Italy

15. Kaplan Heart Center, Kaplan Medical Center Hebrew University of Jerusalem Rehovot Israel

16. Interventional Cardiology Unit, Cardio Thoraco Vascular Department, IRCCS, Azienda Ospedaliera Universitaria, San Martino l’Istituto Scientifico Tumori University of Genoa Genoa Italy

17. Interventional Cardiology Unit IRCCS Humanitas Research Hospital Rozzano‐Milan Italy

18. Interventional Cardiology Unit Gruppo Villa Maria Care and Research Maria Cecilia Hospital Cotignola Italy

19. Department of Cardiac, Vascular, Thoracic Sciences and Public Health University of Padua Padua Italy

Abstract

Background Little is known about the impact of transcatheter mitral valve edge‐to‐edge repair on changes in left ventricular ejection fraction (LVEF) and the effect of an acute reduction in LVEF on prognosis. We aimed to assess changes in LVEF after transcatheter mitral valve edge‐to‐edge repair for both primary and secondary mitral regurgitation (PMR and SMR, respectively), identify rates and predictors of LVEF reduction, and estimate its impact on prognosis. Methods and Results In this international multicenter registry, patients with both PMR and SMR undergoing transcatheter mitral valve edge‐to‐edge repair were included. We assessed rates of acute LVEF reduction (LVEFR), defined as an acute relative decrease of >15% in LVEF, its impact on all‐cause mortality, major adverse cardiac event (composite end point of all‐cause death, mitral valve surgery, and residual mitral regurgitation grade ≥2), and LVEF at 12 months, as well as predictors for LVEFR. Of 2534 patients included (727 with PMR, and 1807 with SMR), 469 (18.5%) developed LVEFR. Patients with PMR were older (79.0±9.2 versus 71.8±8.9 years; P <0.001) and had higher mean LVEF (54.8±14.0% versus 32.7±10.4%; P <0.001) at baseline. After 6 to 12 months (median, 9.9 months; interquartile range, 7.8–11.9 months), LVEF was significantly lower in patients with PMR (53.0% versus 56.0%; P <0.001) but not in patients with SMR. The 1‐year mortality was higher in patients with PMR with LVEFR (16.9% versus 9.7%; P <0.001) but not in those with SMR ( P =0.236). LVEF at baseline (odds ratio, 1.03 [95% CI, 1.01–1.05]; P =0.002) was predictive of LVEFR for patients with PMR, but not those with SMR ( P =0.092). Conclusions Reduction in LVEF is not uncommon after transcatheter mitral valve edge‐to‐edge repair and is correlated with worsened prognosis in patients with PMR but not patients with SMR. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT05311163.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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