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Erschienen in: Clinical Research in Cardiology 3/2018

05.12.2017 | Original Paper

Prognostic value of preprocedural 6-min walk test in patients undergoing transcatheter mitral valve repair—insights from the German transcatheter mitral valve interventions registry

verfasst von: Jakob Ledwoch, Jennifer Franke, Edith Lubos, Peter Boekstegers, Miriam Puls, Taoufik Ouarrak, Stephan von Bardeleben, Christian Butter, Joachim Schofer, Ralf Zahn, Hüsseyin Ince, Jochen Senges, Horst Sievert

Erschienen in: Clinical Research in Cardiology | Ausgabe 3/2018

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Abstract

Aims

The 6-min walk test (6 MWT) has been established as an important tool for functional assessment in heart failure patients. However, its prognostic impact on the outcome in subjects with mitral regurgitation undergoing transcatheter mitral valve repair is unknown.

Methods

This present work represents a sub-analysis of the German, prospective, multicenter, Transcatheter Mitral Valve Interventions (TRAMI) registry. Of the main study cohort (n = 828) 326 patients underwent 6 MWT prior to the procedure. Patients were assigned to two groups depending on the preprocedural 6 MWT distance using the median (< 200 m [group 1] vs. ≥ 200 m [group 2]).

Results

No differences regarding procedural success (97 vs. 96%; p = 0.71) and 30-day mortality (3 vs. 4%; p = 0.96) were observed between the groups. With regards to 1-year outcome, patients with a walking distance < 200 m had higher all-cause mortality (26 vs. 14%; p = 0.013) as compared to those with a 6 MWT distance 200 m. After adjustment of baseline risk factors, 6 MWT distance < 200 m still showed a strong trend towards increased 1-year all-cause mortality (HR 1.63, 95% confidence interval 0.96–2.76; p = 0.071).

Conclusions

In the present study preprocedural 6 MWT distance < 200 m showed a strong trend towards increased 1-year mortality in patients undergoing MitraClip implantation.
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Literatur
1.
Zurück zum Zitat 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(15):1395–406CrossRefPubMed 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(15):1395–406CrossRefPubMed
2.
Zurück zum Zitat Baldus S, Schillinger W, Franzen O, Bekeredjian R, Sievert H, Schofer J, Kuck KH, Konorza T, Mollmann H, Hehrlein C, Ouarrak T, Senges J, Meinertz T (2012) MitraClip therapy in daily clinical practice: initial results from the German transcatheter mitral valve interventions (TRAMI) registry. Eur J Heart Fail 14(9):1050–1055CrossRefPubMed Baldus S, Schillinger W, Franzen O, Bekeredjian R, Sievert H, Schofer J, Kuck KH, Konorza T, Mollmann H, Hehrlein C, Ouarrak T, Senges J, Meinertz T (2012) MitraClip therapy in daily clinical practice: initial results from the German transcatheter mitral valve interventions (TRAMI) registry. Eur J Heart Fail 14(9):1050–1055CrossRefPubMed
3.
Zurück zum Zitat Sorajja P, Mack M, Vemulapalli S, Holmes DR Jr, Stebbins A, Kar S, Lim DS, Thourani V, McCarthy P, Kapadia S, Grayburn P, Pedersen WA, Ailawadi G (2016) Initial experience with commercial transcatheter mitral valve repair in the United States. J Am Coll Cardiol 67(10):1129–1140CrossRefPubMed Sorajja P, Mack M, Vemulapalli S, Holmes DR Jr, Stebbins A, Kar S, Lim DS, Thourani V, McCarthy P, Kapadia S, Grayburn P, Pedersen WA, Ailawadi G (2016) Initial experience with commercial transcatheter mitral valve repair in the United States. J Am Coll Cardiol 67(10):1129–1140CrossRefPubMed
4.
Zurück zum Zitat 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, non-randomized post-approval study of the MitraClip(R) therapy in Europe. J Am Coll Cardiol 62(12):1052–1061CrossRefPubMed 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, non-randomized post-approval study of the MitraClip(R) therapy in Europe. J Am Coll Cardiol 62(12):1052–1061CrossRefPubMed
5.
Zurück zum Zitat Rasekaba T, Lee AL, Naughton MT, Williams TJ, Holland AE (2009) The 6-minute walk test: a useful metric for the cardiopulmonary patient. Intern Med J 39(8):495–501CrossRefPubMed Rasekaba T, Lee AL, Naughton MT, Williams TJ, Holland AE (2009) The 6-minute walk test: a useful metric for the cardiopulmonary patient. Intern Med J 39(8):495–501CrossRefPubMed
6.
Zurück zum Zitat Bettencourt P, Ferreira A, Dias P, Pimenta J, Frioes F, Martins L, Cerqueira-Gomes M (2000) Predictors of prognosis in patients with stable mild to moderate heart failure. J Card Fail 6(4):306–13CrossRefPubMed Bettencourt P, Ferreira A, Dias P, Pimenta J, Frioes F, Martins L, Cerqueira-Gomes M (2000) Predictors of prognosis in patients with stable mild to moderate heart failure. J Card Fail 6(4):306–13CrossRefPubMed
7.
Zurück zum Zitat Bittner V, Weiner DH, Yusuf S, Rogers WJ, McIntyre KM, Bangdiwala SI, Kronenberg MW, Kostis JB, Kohn RM, Guillotte M et al (1993) Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. SOLVD Investig JAMA 270(14):1702–1707 Bittner V, Weiner DH, Yusuf S, Rogers WJ, McIntyre KM, Bangdiwala SI, Kronenberg MW, Kostis JB, Kohn RM, Guillotte M et al (1993) Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. SOLVD Investig JAMA 270(14):1702–1707
8.
Zurück zum Zitat Ingle L, Rigby AS, Carroll S, Butterly R, King RF, Cooke CB, Cleland JG, Clark AL (2007) Prognostic value of the 6 min walk test and self-perceived symptom severity in older patients with chronic heart failure. Eur Heart J 28(5):560–568CrossRefPubMed Ingle L, Rigby AS, Carroll S, Butterly R, King RF, Cooke CB, Cleland JG, Clark AL (2007) Prognostic value of the 6 min walk test and self-perceived symptom severity in older patients with chronic heart failure. Eur Heart J 28(5):560–568CrossRefPubMed
9.
Zurück zum Zitat Zotter-Tufaro C, Mascherbauer J, Duca F, Koell B, Aschauer S, Kammerlander AA, Panzenboeck A, Sadushi-Kolici R, Bangert C, Laimer D, Ristl R, Lang IM, Bonderman D (2015) Prognostic significance and determinants of the 6-min walk test in patients with heart failure and preserved ejection Fraction. JACC Heart Fail 3(6):459–66CrossRefPubMed Zotter-Tufaro C, Mascherbauer J, Duca F, Koell B, Aschauer S, Kammerlander AA, Panzenboeck A, Sadushi-Kolici R, Bangert C, Laimer D, Ristl R, Lang IM, Bonderman D (2015) Prognostic significance and determinants of the 6-min walk test in patients with heart failure and preserved ejection Fraction. JACC Heart Fail 3(6):459–66CrossRefPubMed
10.
Zurück zum Zitat Puls M, Lubos E, Boekstegers P, von Bardeleben RS, Ouarrak T, Butter C, Zuern CS, Bekeredjian R, Sievert H, Nickenig G, Eggebrecht H, Senges J, Schillinger W (2016) One-year outcomes and predictors of mortality after MitraClip therapy in contemporary clinical practice: results from the German transcatheter mitral valve interventions registry. Eur Heart J 37(8):703–12CrossRefPubMed Puls M, Lubos E, Boekstegers P, von Bardeleben RS, Ouarrak T, Butter C, Zuern CS, Bekeredjian R, Sievert H, Nickenig G, Eggebrecht H, Senges J, Schillinger W (2016) One-year outcomes and predictors of mortality after MitraClip therapy in contemporary clinical practice: results from the German transcatheter mitral valve interventions registry. Eur Heart J 37(8):703–12CrossRefPubMed
11.
Zurück zum Zitat 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(7):777–802CrossRefPubMed 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(7):777–802CrossRefPubMed
12.
Zurück zum Zitat Roques F, Nashef SA, Michel P (2001) Risk factors for early mortality after valve surgery in Europe in the 1990s: lessons from the EuroSCORE pilot program. J Heart Valve Dis 10(5):572–577 (discussion 577–8) PubMed Roques F, Nashef SA, Michel P (2001) Risk factors for early mortality after valve surgery in Europe in the 1990s: lessons from the EuroSCORE pilot program. J Heart Valve Dis 10(5):572–577 (discussion 577–8) PubMed
13.
Zurück zum Zitat Laboratories A.T.S.C.o.P.S.f.C.P.F. (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166(1):111–117CrossRef Laboratories A.T.S.C.o.P.S.f.C.P.F. (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166(1):111–117CrossRef
14.
Zurück zum Zitat Saji M, Ailawadi G, Welch TS, Downs E, LaPar DJ, Ghanta R, Kennedy JL, Abuannadi M, Buda AJ, Bergin JD, Kern JA, Dent JM, Ragosta M, Lim DS (2016) Pre-procedural 6-min walk test as a mortality predictor in patients undergoing transcatheter mitral valve repair. J Am Coll Cardiol 67(17):2083–2084CrossRefPubMed Saji M, Ailawadi G, Welch TS, Downs E, LaPar DJ, Ghanta R, Kennedy JL, Abuannadi M, Buda AJ, Bergin JD, Kern JA, Dent JM, Ragosta M, Lim DS (2016) Pre-procedural 6-min walk test as a mortality predictor in patients undergoing transcatheter mitral valve repair. J Am Coll Cardiol 67(17):2083–2084CrossRefPubMed
15.
Zurück zum Zitat Forman DE, Fleg JL, Kitzman DW, Brawner CA, Swank AM, McKelvie RS, Clare RM, Ellis SJ, Dunlap ME, Bittner V (2012) 6-min walk test provides prognostic utility comparable to cardiopulmonary exercise testing in ambulatory outpatients with systolic heart failure. J Am Coll Cardiol 60(25):2653–2661CrossRefPubMedPubMedCentral Forman DE, Fleg JL, Kitzman DW, Brawner CA, Swank AM, McKelvie RS, Clare RM, Ellis SJ, Dunlap ME, Bittner V (2012) 6-min walk test provides prognostic utility comparable to cardiopulmonary exercise testing in ambulatory outpatients with systolic heart failure. J Am Coll Cardiol 60(25):2653–2661CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Rostagno C, Olivo G, Comeglio M, Boddi V, Banchelli M, Galanti G, Gensini GF (2003) Prognostic value of 6-minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation. Eur J Heart Fail 5(3):247–52CrossRefPubMed Rostagno C, Olivo G, Comeglio M, Boddi V, Banchelli M, Galanti G, Gensini GF (2003) Prognostic value of 6-minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation. Eur J Heart Fail 5(3):247–52CrossRefPubMed
17.
Zurück zum Zitat Prakash R, Horsfall M, Markwick A, Pumar M, Lee L, Sinhal A, Joseph MX, Chew DP (2014) Prognostic impact of moderate or severe mitral regurgitation (MR) irrespective of concomitant comorbidities: a retrospective matched cohort study. BMJ Open 4(7):e004984CrossRefPubMedPubMedCentral Prakash R, Horsfall M, Markwick A, Pumar M, Lee L, Sinhal A, Joseph MX, Chew DP (2014) Prognostic impact of moderate or severe mitral regurgitation (MR) irrespective of concomitant comorbidities: a retrospective matched cohort study. BMJ Open 4(7):e004984CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Swaans MJ, Bakker AL, Alipour A, Post MC, Kelder JC, de Kroon TL, Eefting FD, Rensing BJ, Van der Heyden JA (2014) Survival of transcatheter mitral valve repair compared with surgical and conservative treatment in high-surgical-risk patients. JACC Cardiovasc Interv 7(8):875–81CrossRefPubMed Swaans MJ, Bakker AL, Alipour A, Post MC, Kelder JC, de Kroon TL, Eefting FD, Rensing BJ, Van der Heyden JA (2014) Survival of transcatheter mitral valve repair compared with surgical and conservative treatment in high-surgical-risk patients. JACC Cardiovasc Interv 7(8):875–81CrossRefPubMed
19.
20.
Zurück zum Zitat Leikis MJ, McKenna MJ, Petersen AC, Kent AB, Murphy KT, Leppik JA, Gong X, McMahon LP (2006) Exercise performance falls over time in patients with chronic kidney disease despite maintenance of hemoglobin concentration. Clin J Am Soc Nephrol 1(3):488–95CrossRefPubMed Leikis MJ, McKenna MJ, Petersen AC, Kent AB, Murphy KT, Leppik JA, Gong X, McMahon LP (2006) Exercise performance falls over time in patients with chronic kidney disease despite maintenance of hemoglobin concentration. Clin J Am Soc Nephrol 1(3):488–95CrossRefPubMed
Metadaten
Titel
Prognostic value of preprocedural 6-min walk test in patients undergoing transcatheter mitral valve repair—insights from the German transcatheter mitral valve interventions registry
verfasst von
Jakob Ledwoch
Jennifer Franke
Edith Lubos
Peter Boekstegers
Miriam Puls
Taoufik Ouarrak
Stephan von Bardeleben
Christian Butter
Joachim Schofer
Ralf Zahn
Hüsseyin Ince
Jochen Senges
Horst Sievert
Publikationsdatum
05.12.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Research in Cardiology / Ausgabe 3/2018
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-017-1177-z

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