Mortality Associated With Proportionality of Secondary Mitral Regurgitation After Transcatheter Mitral Valve Repair: North American Mitraclip for Functional Mitral Regurgitation Registry

被引:2
|
作者
Duggal, Neal M. [1 ]
Engoren, Milo [1 ]
Chadderdon, Scott M. [2 ]
Rodriguez, Evelio [3 ]
Morse, M. Andrew [4 ]
Vannan, Mani A. [5 ]
Yadav, Pradeep K. [5 ]
Morcos, Michael [6 ]
Li, Flora [7 ]
Reisman, Mark [8 ]
Garcia-Sayan, Enrique [9 ]
Raghunathan, Deepa [9 ]
Sodhi, Nishtha [10 ]
Sorajja, Paul [11 ]
Chen, Lily [12 ]
Rogers, Jason H. [12 ]
Calfon, Marcella A. [13 ]
Kovach, Christopher P. [14 ]
Gill, Edward A. [14 ]
Zahr, Firas E. [2 ]
Chetcuti, Stanley J. [15 ]
Yuan, Yuan [1 ]
Mentz, Graciela B. [1 ]
Lim, D. Scott [10 ]
Ailawadi, Gorav [16 ]
机构
[1] Univ Michigan, Dept Anesthesiol, Ann Arbor, MI 48109 USA
[2] Oregon Hlth & Sci Univ, Knight Cardiovasc Inst, Div Cardiol, Portland, OR USA
[3] Ascens St Thomas Heart, Dept Cardiothorac Surg, Nashville, TN USA
[4] Ascens St Thomas Heart, Div Cardiol, Nashville, TN USA
[5] Piedmont Heart Inst, Marcus Heart Valve Ctr, Atlanta, GA USA
[6] Univ Washington, Div Cardiol, Seattle, WA USA
[7] Univ Washington, Dept Anesthesiol, Seattle, WA USA
[8] Weill Cornell Med Ctr, Div Cardiol, New York, NY USA
[9] Univ Texas Hlth Sci Ctr Houston, Div Cardiovasc Med, Houston, TX USA
[10] Univ Virginia, Div Cardiovasc Med, Charlottesville, VA USA
[11] Abbott Northwestern Med Ctr, Minneapolis Heart Inst, Valve Sci Ctr, Minneapolis, MN USA
[12] Univ Calif Davis, Med Ctr, Div Cardiovasc Med, Sacramento, CA USA
[13] Univ Calif Los Angeles, Div Cardiol, Los Angeles, CA USA
[14] Univ Colorado, Div Cardiol, Aurora, CO USA
[15] Univ Michigan, Div Cardiovasc Med, Ann Arbor, MI USA
[16] Univ Michigan, Dept Cardiac Surg, Ann Arbor, MI USA
来源
AMERICAN JOURNAL OF CARDIOLOGY | 2024年 / 213卷
关键词
proportionality; functional mitral regurgitation; regurgitant orifice; mitral transcath-eter edge-to-edge repair; VALVULAR REGURGITATION; ECHOCARDIOGRAPHY; SOCIETY; RECOMMENDATIONS; COLLABORATION; REPLACEMENT; PREDICTORS; REGRESSION; IMPACT;
D O I
10.1016/j.amjcard.2023.12.020
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The association, if any, between the effective regurgitant orifice area (EROA) to left ventricular end-diastolic volume (LVEDV) ratio and 1-year mortality is controversial in patients who undergo mitral transcatheter edge-to-edge repair (m-TEER) with the MitraClip system (Abbott Vascular, Santa Clara, CA). This study's objective was to determine the association between EROA/LVEDV and 1-year mortality in patients who undergo mTEER with MitraClip. In patients with severe secondary (functional) mitral regurgitation (MR), we analyzed registry data from 11 centers using generalized linear models with the generalized estimating equations approach. We studied 525 patients with secondary MR who underwent m-TEER. Most patients were male (63%) and were New York Heart Association class III (61%) or IV (21%). Mitral regurgitation was caused by ischemic cardiomyopathy in 51% of patients. EROA/LVEDV values varied widely, with median = 0.19 mm2/ml, interquartile range [0.12,0.28] mm2/ml, and 187 patients (36%) had values <0.15 mm2/ml. Postprocedural mitral regurgitation severity was substantially alleviated, being 1 + or less in 74%, 2+ in 20%, 3+ in 4%, and 4+ in 2%; 1-year mortality was 22%. After adjustment for confounders, the logarithmic transformation (Ln) of EROA/LVEDV was associated with 1-year mortality (odds ratio 0.600, 95% confidence interval 0.386 to 0.933, p = 0.023). A higher Society of Thoracic Surgeons risk score was also associated with increased mortality. In conclusion, lower values of Ln(EROA/LVEDV) were associated with increased 1-year mortality in this multicenter registry. The slope of the association is steep at low values but gradually flattens as Ln(EROA/LVEDV) increases. (c) 2023 Elsevier Inc. All rights reserved.
引用
收藏
页码:99 / 105
页数:7
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