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Heart and Vessels

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11.03.2016 | Original Article

Impact of left ventricular systolic dysfunction on the outcomes of percutaneous edge-to-edge mitral valve repair using MitraClip

verfasst von: Hidehiro Kaneko, Michael Neuss, Thomas Schau, Jens Weissenborn, Christian Butter

Erschienen in: Heart and Vessels | Ausgabe 12/2016

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Abstract

Left ventricular systolic dysfunction (LVD) is associated with poor outcomes after mitral regurgitation (MR) surgery. MitraClip (MC) is a novel treatment option for MR patients with a high surgical risk. However, outcomes of LVD patients underwent MC remain unclear. In total of 194 patients after MC implantation, 75 patients (39 %) had severe LVD (LV ejection fraction ≤30 %). Patients with severe LVD were primarily male and also younger. Logistic euroSCOREs were comparable between the two groups. Functional MR was more common in patients with severe LVD, while New York Heart Association (NYHA) class was similar between the two groups. N-terminal pro-B-type natriuretic peptide (NT-proBNP) was significantly higher in patients with LVD. In addition to similar improvements in MR severity, NYHA class, and NT-proBNP levels, the survival rates were not different between patients with and without severe LVD. Among patients with severe LVD, the long-term survival rates were significantly lower in patients aged ≥75 years, those with NT-proBNP >5000 pg/mL, and those with atrial fibrillation (AF). In conclusion, severe LVD was not associated with the mortality after MC implantation. MC might be feasible and effective even in the patients with severe MR and low LVEF. However, we need to carefully observe severe LVD patients who are elderly, have a high NT-proBNP level, and have AF, as these might be considered high-risk subjects.

Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, O’Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM 3rd, Thomas JD (2014) 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63:e57–185CrossRefPubMed

Delahaye JP, Gare JP, Viguier E, Delahaye F, De Gevigney G, Milon H (1991) Natural history of severe mitral regurgitation. Eur Heart J 12(Suppl B):5–9CrossRefPubMed

Ling LH, Enriquez-Sarano M, Seward JB, Tajik AJ, Schaff HV, Bailey KR, Frye RL (1996) Clinical outcome of mitral regurgitation due to flail leaflet. N Engl J Med 335:1417–1423CrossRefPubMed

Enriquez-Sarano M, Tajik AJ, Schaff HV, Orszulak TA, Bailey KR, Frye RL (1994) Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation 90:830–837CrossRefPubMed

Mirabel M, Iung B, Baron G, Messika-Zeitoun D, Detaint D, Vanoverschelde JL, Butchart EG, Ravaud P, Vahanian A (2007) What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery? Eur Heart J 28:1358–1365CrossRefPubMed

Feldman T, Wasserman HS, Herrmann HC, Gray W, Block PC, Whitlow P, St Goar F, Rodriguez L, Silvestry F, Schwartz A, Sanborn TA, Condado JA, Foster E (2005) Percutaneous mitral valve repair using the edge-to-edge technique: six-month results of the EVEREST Phase I Clinical Trial. J Am Coll Cardiol 46:2134–2140CrossRefPubMed

Herrmann HC, Rohatgi S, Wasserman HS, Block P, Gray W, Hamilton A, Zunamon A, Homma S, Di Tullio MR, Kraybill K, Merlino J, Martin R, Rodriguez L, Stewart WJ, Whitlow P, Wiegers SE, Silvestry FE, Foster E, Feldman T (2006) Mitral valve hemodynamic effects of percutaneous edge-to-edge repair with the MitraClip device for mitral regurgitation. Catheter Cardiovasc Interv 68:821–828CrossRefPubMed

Herrmann HC, Kar S, Siegel R, Fail P, Loghin C, Lim S, Hahn R, Rogers JH, Bommer WJ, Wang A, Berke A, Lerakis S, Kramer P, Wong SC, Foster E, Glower D, Feldman T (2009) Effect of percutaneous mitral repair with the MitraClip device on mitral valve area and gradient. EuroIntervention 4:437–442CrossRefPubMed

Feldman T, Kar S, Rinaldi M, Fail P, Hermiller J, Smalling R, Whitlow PL, Gray W, Low R, Herrmann HC, Lim S, Foster E, Glower D (2009) Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort. J Am Coll Cardiol 54:686–694CrossRefPubMed

10.

Feldman T, Foster E, Glower DD, Kar S, Rinaldi MJ, Fail PS, Smalling RW, Siegel R, Rose GA, Engeron E, Loghin C, Trento A, Skipper ER, Fudge T, Letsou GV, Massaro JM, Mauri L (2011) Percutaneous repair or surgery for mitral regurgitation. N Engl J Med 364:1395–1406CrossRefPubMed

11.

Siegel RJ, Biner S, Rafique AM, Rinaldi M, Lim S, Fail P, Hermiller J, Smalling R, Whitlow PL, Herrmann HC, Foster E, Feldman T, Glower D, Kar S (2011) The acute hemodynamic effects of MitraClip therapy. J Am Coll Cardiol 57:1658–1665CrossRefPubMed

12.

Tamburino C, Ussia GP, Maisano F, Capodanno D, La Canna G, Scandura S, Colombo A, Giacomini A, Michev I, Mangiafico S, Cammalleri V, Barbanti M, Alfieri O (2010) Percutaneous mitral valve repair with the MitraClip system: acute results from a real world setting. Eur Heart J 31:1382–1389CrossRefPubMedPubMedCentral

13.

Schillinger W, Athanasiou T, Weicken N, Berg L, Tichelbacker T, Puls M, Hunlich M, Wachter R, Helms HJ, Seipelt R, Schondube FA, Hasenfuss G (2011) Impact of the learning curve on outcomes after percutaneous mitral valve repair with MitraClip and lessons learned after the first 75 consecutive patients. Eur J Heart Fail 13:1331–1339CrossRefPubMed

14.

Ussia GP, Cammalleri V, Mazzotta E, Pascuzzo G, Muscoli S, Marchei M, Macrini M, Anceschi A, Romeo F (2015) Cardiovascular medicine heart failure (CVM-HF) index as prognostic model for candidates to MitraClip therapy. Heart Vessels. doi:10.1007/s00380-015-0772-z PubMed

15.

Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA, Nihoyannopoulos P, Otto CM, Quinones MA, Rakowski H, Stewart WJ, Waggoner A, Weissman NJ (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 16:777–802CrossRefPubMed

16.

Foster E, Wasserman HS, Gray W, Homma S, Di Tullio MR, Rodriguez L, Stewart WJ, Whitlow P, Block P, Martin R, Merlino J, Herrmann HC, Wiegers SE, Silvestry FE, Hamilton A, Zunamon A, Kraybill K, Gerber IL, Weeks SG, Zhang Y, Feldman T (2007) Quantitative assessment of severity of mitral regurgitation by serial echocardiography in a multicenter clinical trial of percutaneous mitral valve repair. Am J Cardiol 100:1577–1583CrossRefPubMed

17.

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med 130:461–470CrossRefPubMed

18.

Seifert M, Schau T, Schoepp M, Arya A, Neuss M, Butter C (2014) MitraClip in CRT non-responders with severe mitral regurgitation. Int J Cardiol 177:79–85CrossRefPubMed

19.

Maisano F, Franzen O, Baldus S, Schafer U, Hausleiter J, Butter C, Ussia GP, Sievert H, Richardt G, Widder JD, Moccetti T, Schillinger W (2013) Percutaneous mitral valve interventions in the real world: early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol 62:1052–1061CrossRefPubMed

20.

Nickenig G, Estevez-Loureiro R, Franzen O, Tamburino C, Vanderheyden M, Luscher TF, Moat N, Price S, Dall’Ara G, Winter R, Corti R, Grasso C, Snow TM, Jeger R, Blankenberg S, Settergren M, Tiroch K, Balzer J, Petronio AS, Buttner HJ, Ettori F, Sievert H, Fiorino MG, Claeys M, Ussia GP, Baumgartner H, Scandura S, Alamgir F, Keshavarzi F, Colombo A, Maisano F, Ebelt H, Aruta P, Lubos E, Plicht B, Schueler R, Pighi M, Di Mario C (2014) Percutaneous mitral valve edge-to-edge repair: in-hospital results and 1-year follow-up of 628 patients of the 2011-2012 Pilot European Sentinel Registry. J Am Coll Cardiol 64:875–884CrossRefPubMed

21.

Schueler R, Nickenig G, May AE, Schillinger W, Bekeredjian R, Ouarrak T, Schofer J, Hehrlein C, Sievert H, Boekstegers P, Lubos E, Hoffmann R, Baldus S, Senges J, Hammerstingl C (2015) Predictors for short-term outcomes of patients undergoing transcatheter mitral valve interventions: analysis of 778 prospective patients from the German TRAMI registry focusing on baseline renal function. EuroIntervention 11(5). doi:10.4244/EIJY15M09_07

22.

Kaneko H, Suzuki S, Uejima T, Kano H, Matsuno S, Otsuka T, Takai H, Oikawa Y, Yajima J, Koike A, Nagashima K, Kirigaya H, Sagara K, Tanabe H, Sawada H, Aizawa T, Yamashita T (2014) Prevalence and the long-term prognosis of functional mitral regurgitation in Japanese patients with symptomatic heart failure. Heart Vessels 29:801–807CrossRefPubMed

23.

Kaneko H, Suzuki S, Uejima T, Kano H, Matsuno S, Takai H, Oikawa Y, Yajima J, Aizawa T, Yamashita T (2014) Functional mitral regurgitation and left ventricular systolic dysfunction in the recent era of cardiovascular clinical practice, an observational cohort study. Hypertens Res 37:1082–1087CrossRefPubMed

24.

Grasso C, Capodanno D, Scandura S, Cannata S, Imme S, Mangiafico S, Pistritto A, Ministeri M, Barbanti M, Caggegi A, Chiaranda M, Dipasqua F, Giaquinta S, Occhipinti M, Ussia G, Tamburino C (2013) One- and twelve-month safety and efficacy outcomes of patients undergoing edge-to-edge percutaneous mitral valve repair (from the GRASP Registry). Am J Cardiol 111:1482–1487CrossRefPubMed

25.

Rudolph V, Lubos E, Schluter M, Lubs D, Goldmann B, Knap M, de Vries T, Treede H, Schirmer J, Conradi L, Wegscheider K, Reichenspurner H, Blankenberg S, Baldus S (2013) Aetiology of mitral regurgitation differentially affects 2-year adverse outcomes after MitraClip therapy in high-risk patients. Eur J Heart Fail 15:796–807CrossRefPubMed

26.

Neuss M, Schau T, Schoepp M, Seifert M, Holschermann F, Meyhofer J, Butter C (2013) Patient selection criteria and midterm clinical outcome for MitraClip therapy in patients with severe mitral regurgitation and severe congestive heart failure. Eur J Heart Fail 15:786–795CrossRefPubMed

27.

Schau T, Isotani A, Neuss M, Schopp M, Seifert M, Hopfner C, Burkhoff D, Butter C (2015) Long-term survival after MitraClip therapy in patients with severe mitral regurgitation and severe congestive heart failure: a comparison among survivals predicted by heart failure models. J Cardiol. doi:10.1016/j.jjcc.2015.05.015 PubMed

28.

Crijns HJ, Tjeerdsma G, de Kam PJ, Boomsma F, van Gelder IC, van den Berg MP, van Veldhuisen DJ (2000) Prognostic value of the presence and development of atrial fibrillation in patients with advanced chronic heart failure. Eur Heart J 21:1238–1245CrossRefPubMed

29.

Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, D’Agostino RB, Murabito JM, Kannel WB, Benjamin EJ (2003) Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation 107:2920–2925CrossRefPubMed

30.

Rusinaru D, Leborgne L, Peltier M, Tribouilloy C (2008) Effect of atrial fibrillation on long-term survival in patients hospitalised for heart failure with preserved ejection fraction. Eur J Heart Fail 10:566–572CrossRefPubMed

31.

Hamaguchi S, Yokoshiki H, Kinugawa S, Tsuchihashi-Makaya M, Yokota T, Takeshita A, Tsutsui H (2009) Effects of atrial fibrillation on long-term outcomes in patients hospitalized for heart failure in Japan: a report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J 73:2084–2090CrossRefPubMed

Titel: Impact of left ventricular systolic dysfunction on the outcomes of percutaneous edge-to-edge mitral valve repair using MitraClip
verfasst von: Hidehiro Kaneko
Michael Neuss
Thomas Schau
Jens Weissenborn
Christian Butter
Publikationsdatum: 11.03.2016
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 12/2016
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-016-0822-1

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