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Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair

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Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair. / Stolz, Lukas; Doldi, Philipp M; Orban, Mathias; Karam, Nicole; Puscas, Tania; Wild, Mirjam G; Popescu, Aniela; von Bardeleben, Ralph Stephan; Iliadis, Christos; Baldus, Stephan; Adamo, Marianna; Thiele, Holger; Besler, Christian; Unterhuber, Matthias; Ruf, Tobias; Pfister, Roman; Higuchi, Satoshi; Koell, Benedikt; Giannini, Christina; Petronio, Anna; Kassar, Mohammad; Weckbach, Ludwig T; Butter, Christian; Stocker, Thomas J; Neuss, Michael; Melica, Bruno; Braun, Daniel; Windecker, Stephan; Massberg, Steffen; Praz, Fabien; Näbauer, Micheal; Kalbacher, Daniel; Lurz, Philipp; Metra, Marco; Bax, Jeroen J; Hausleiter, Jörg; EuroSMR Investigators.

In: JACC-CARDIOVASC INTE, Vol. 16, No. 2, 23.01.2023, p. 140-151.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Stolz, L, Doldi, PM, Orban, M, Karam, N, Puscas, T, Wild, MG, Popescu, A, von Bardeleben, RS, Iliadis, C, Baldus, S, Adamo, M, Thiele, H, Besler, C, Unterhuber, M, Ruf, T, Pfister, R, Higuchi, S, Koell, B, Giannini, C, Petronio, A, Kassar, M, Weckbach, LT, Butter, C, Stocker, TJ, Neuss, M, Melica, B, Braun, D, Windecker, S, Massberg, S, Praz, F, Näbauer, M, Kalbacher, D, Lurz, P, Metra, M, Bax, JJ, Hausleiter, J & EuroSMR Investigators 2023, 'Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair', JACC-CARDIOVASC INTE, vol. 16, no. 2, pp. 140-151. https://doi.org/10.1016/j.jcin.2022.10.032

APA

Stolz, L., Doldi, P. M., Orban, M., Karam, N., Puscas, T., Wild, M. G., Popescu, A., von Bardeleben, R. S., Iliadis, C., Baldus, S., Adamo, M., Thiele, H., Besler, C., Unterhuber, M., Ruf, T., Pfister, R., Higuchi, S., Koell, B., Giannini, C., ... EuroSMR Investigators (2023). Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair. JACC-CARDIOVASC INTE, 16(2), 140-151. https://doi.org/10.1016/j.jcin.2022.10.032

Vancouver

Stolz L, Doldi PM, Orban M, Karam N, Puscas T, Wild MG et al. Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair. JACC-CARDIOVASC INTE. 2023 Jan 23;16(2):140-151. https://doi.org/10.1016/j.jcin.2022.10.032

Bibtex

@article{6a428b85618d4d4fb27cfc168b665452,
title = "Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair",
abstract = "BACKGROUND: Secondary mitral regurgitation (SMR) is a progressive disease with characteristic pathophysiological changes that may influence prognosis. Although the staging of SMR patients suffering from heart failure with reduced ejection fraction (HFrEF) according to extramitral cardiac involvement has prognostic value in medically treated patients, such data are so far lacking for edge-to-edge mitral valve repair (M-TEER).OBJECTIVES: This study sought to classify M-TEER patients into disease stages based on the phenotype of extramitral cardiac involvement and to assess its impact on symptomatic and survival outcomes.METHODS: Based on echocardiographic and clinical assessment, patients were assigned to 1 of the following HFrEF-SMR groups: left ventricular involvement (Stage 1), left atrial involvement (Stage 2), right ventricular volume/pressure overload (Stage 3), or biventricular failure (Stage 4). A Cox regression model was implemented to investigate the impact of HFrEF-SMR stages on 2-year all-cause mortality. The symptomatic outcome was assessed with New York Heart Association functional class at follow-up.RESULTS: Among a total of 849 eligible patients who underwent M-TEER for relevant SMR from 2008 until 2019, 9.5% (n = 81) presented with left ventricular involvement, 46% (n = 393) with left atrial involvement, 15% (n = 129) with right ventricular pressure/volume overload, and 29% (n = 246) with biventricular failure. An increase in HFrEF-SMR stage was associated with increased 2-year all-cause mortality after M-TEER (HR: 1.39; CI: 1.23-1.58; P < 0.01). Furthermore, higher HFrEF-SMR stages were associated with significantly less symptomatic improvement at follow-up.CONCLUSIONS: The classification of M-TEER patients into HFrEF-SMR stages according to extramitral cardiac involvement provides prognostic value in terms of postinterventional survival and symptomatic improvement.",
keywords = "Humans, Mitral Valve Insufficiency/diagnostic imaging, Heart Failure/diagnostic imaging, Mitral Valve/diagnostic imaging, Heart Valve Prosthesis Implantation/adverse effects, Atrial Fibrillation, Treatment Outcome, Stroke Volume",
author = "Lukas Stolz and Doldi, {Philipp M} and Mathias Orban and Nicole Karam and Tania Puscas and Wild, {Mirjam G} and Aniela Popescu and {von Bardeleben}, {Ralph Stephan} and Christos Iliadis and Stephan Baldus and Marianna Adamo and Holger Thiele and Christian Besler and Matthias Unterhuber and Tobias Ruf and Roman Pfister and Satoshi Higuchi and Benedikt Koell and Christina Giannini and Anna Petronio and Mohammad Kassar and Weckbach, {Ludwig T} and Christian Butter and Stocker, {Thomas J} and Michael Neuss and Bruno Melica and Daniel Braun and Stephan Windecker and Steffen Massberg and Fabien Praz and Micheal N{\"a}bauer and Daniel Kalbacher and Philipp Lurz and Marco Metra and Bax, {Jeroen J} and J{\"o}rg Hausleiter and {EuroSMR Investigators}",
note = "Copyright {\textcopyright} 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2023",
month = jan,
day = "23",
doi = "10.1016/j.jcin.2022.10.032",
language = "English",
volume = "16",
pages = "140--151",
journal = "JACC-CARDIOVASC INTE",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "2",

}

RIS

TY - JOUR

T1 - Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair

AU - Stolz, Lukas

AU - Doldi, Philipp M

AU - Orban, Mathias

AU - Karam, Nicole

AU - Puscas, Tania

AU - Wild, Mirjam G

AU - Popescu, Aniela

AU - von Bardeleben, Ralph Stephan

AU - Iliadis, Christos

AU - Baldus, Stephan

AU - Adamo, Marianna

AU - Thiele, Holger

AU - Besler, Christian

AU - Unterhuber, Matthias

AU - Ruf, Tobias

AU - Pfister, Roman

AU - Higuchi, Satoshi

AU - Koell, Benedikt

AU - Giannini, Christina

AU - Petronio, Anna

AU - Kassar, Mohammad

AU - Weckbach, Ludwig T

AU - Butter, Christian

AU - Stocker, Thomas J

AU - Neuss, Michael

AU - Melica, Bruno

AU - Braun, Daniel

AU - Windecker, Stephan

AU - Massberg, Steffen

AU - Praz, Fabien

AU - Näbauer, Micheal

AU - Kalbacher, Daniel

AU - Lurz, Philipp

AU - Metra, Marco

AU - Bax, Jeroen J

AU - Hausleiter, Jörg

AU - EuroSMR Investigators

N1 - Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2023/1/23

Y1 - 2023/1/23

N2 - BACKGROUND: Secondary mitral regurgitation (SMR) is a progressive disease with characteristic pathophysiological changes that may influence prognosis. Although the staging of SMR patients suffering from heart failure with reduced ejection fraction (HFrEF) according to extramitral cardiac involvement has prognostic value in medically treated patients, such data are so far lacking for edge-to-edge mitral valve repair (M-TEER).OBJECTIVES: This study sought to classify M-TEER patients into disease stages based on the phenotype of extramitral cardiac involvement and to assess its impact on symptomatic and survival outcomes.METHODS: Based on echocardiographic and clinical assessment, patients were assigned to 1 of the following HFrEF-SMR groups: left ventricular involvement (Stage 1), left atrial involvement (Stage 2), right ventricular volume/pressure overload (Stage 3), or biventricular failure (Stage 4). A Cox regression model was implemented to investigate the impact of HFrEF-SMR stages on 2-year all-cause mortality. The symptomatic outcome was assessed with New York Heart Association functional class at follow-up.RESULTS: Among a total of 849 eligible patients who underwent M-TEER for relevant SMR from 2008 until 2019, 9.5% (n = 81) presented with left ventricular involvement, 46% (n = 393) with left atrial involvement, 15% (n = 129) with right ventricular pressure/volume overload, and 29% (n = 246) with biventricular failure. An increase in HFrEF-SMR stage was associated with increased 2-year all-cause mortality after M-TEER (HR: 1.39; CI: 1.23-1.58; P < 0.01). Furthermore, higher HFrEF-SMR stages were associated with significantly less symptomatic improvement at follow-up.CONCLUSIONS: The classification of M-TEER patients into HFrEF-SMR stages according to extramitral cardiac involvement provides prognostic value in terms of postinterventional survival and symptomatic improvement.

AB - BACKGROUND: Secondary mitral regurgitation (SMR) is a progressive disease with characteristic pathophysiological changes that may influence prognosis. Although the staging of SMR patients suffering from heart failure with reduced ejection fraction (HFrEF) according to extramitral cardiac involvement has prognostic value in medically treated patients, such data are so far lacking for edge-to-edge mitral valve repair (M-TEER).OBJECTIVES: This study sought to classify M-TEER patients into disease stages based on the phenotype of extramitral cardiac involvement and to assess its impact on symptomatic and survival outcomes.METHODS: Based on echocardiographic and clinical assessment, patients were assigned to 1 of the following HFrEF-SMR groups: left ventricular involvement (Stage 1), left atrial involvement (Stage 2), right ventricular volume/pressure overload (Stage 3), or biventricular failure (Stage 4). A Cox regression model was implemented to investigate the impact of HFrEF-SMR stages on 2-year all-cause mortality. The symptomatic outcome was assessed with New York Heart Association functional class at follow-up.RESULTS: Among a total of 849 eligible patients who underwent M-TEER for relevant SMR from 2008 until 2019, 9.5% (n = 81) presented with left ventricular involvement, 46% (n = 393) with left atrial involvement, 15% (n = 129) with right ventricular pressure/volume overload, and 29% (n = 246) with biventricular failure. An increase in HFrEF-SMR stage was associated with increased 2-year all-cause mortality after M-TEER (HR: 1.39; CI: 1.23-1.58; P < 0.01). Furthermore, higher HFrEF-SMR stages were associated with significantly less symptomatic improvement at follow-up.CONCLUSIONS: The classification of M-TEER patients into HFrEF-SMR stages according to extramitral cardiac involvement provides prognostic value in terms of postinterventional survival and symptomatic improvement.

KW - Humans

KW - Mitral Valve Insufficiency/diagnostic imaging

KW - Heart Failure/diagnostic imaging

KW - Mitral Valve/diagnostic imaging

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Atrial Fibrillation

KW - Treatment Outcome

KW - Stroke Volume

U2 - 10.1016/j.jcin.2022.10.032

DO - 10.1016/j.jcin.2022.10.032

M3 - SCORING: Journal article

C2 - 36697148

VL - 16

SP - 140

EP - 151

JO - JACC-CARDIOVASC INTE

JF - JACC-CARDIOVASC INTE

SN - 1936-8798

IS - 2

ER -