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The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation

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The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation. / Reichart, Daniel; Kalbacher, Daniel; Rübsamen, Nicole; Tigges, Eike; Thomas, Christina; Schirmer, Johannes; Reichenspurner, Hermann; Blankenberg, Stefan; Conradi, Lenard; Schäfer, Ulrich; Lubos, Edith.

In: EUR J HEART FAIL, Vol. 22, No. 10, 10.2020, p. 1840-1848.

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

Harvard

Reichart, D, Kalbacher, D, Rübsamen, N, Tigges, E, Thomas, C, Schirmer, J, Reichenspurner, H, Blankenberg, S, Conradi, L, Schäfer, U & Lubos, E 2020, 'The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation', EUR J HEART FAIL, vol. 22, no. 10, pp. 1840-1848. https://doi.org/10.1002/ejhf.1774

APA

Reichart, D., Kalbacher, D., Rübsamen, N., Tigges, E., Thomas, C., Schirmer, J., Reichenspurner, H., Blankenberg, S., Conradi, L., Schäfer, U., & Lubos, E. (2020). The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation. EUR J HEART FAIL, 22(10), 1840-1848. https://doi.org/10.1002/ejhf.1774

Vancouver

Reichart D, Kalbacher D, Rübsamen N, Tigges E, Thomas C, Schirmer J et al. The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation. EUR J HEART FAIL. 2020 Oct;22(10):1840-1848. https://doi.org/10.1002/ejhf.1774

Bibtex

@article{a9c5508328e041b090951777bac2d08f,
title = "The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation",
abstract = "AIMS: MitraClip therapy for the treatment of functional mitral regurgitation (FMR) is an increasingly used intervention for high-risk surgical patients. The aim of this observational study was to assess the impact of residual mitral regurgitation (rMR) at discharge on long-term outcome after MitraClip therapy in patients with FMR.METHODS AND RESULTS: Overall, 458 patients (mean age 73.8 ± 8.9 years) underwent MitraClip implantation between September 2008 and December 2017. The impact of rMR ≤ 1+ at discharge (n = 251) was retrospectively compared to patients graded as rMR 2+ (n = 173) and rMR ≥3+ (n = 34) at discharge. Median follow-up time was 5.09 years (5.00-5.26) with maximum follow-up of 10.02 years. The primary outcome was survival, and Kaplan-Meier analyses revealed significant differences among all rMR subgroups with highest survival rates for rMR ≤ 1+ patients. This was further confirmed by composite outcome analyses (P < 0.02). The inferior outcomes of rMR 2+ and rMR ≥ 3+ at discharge were confirmed by increased adjusted hazard ratios when rMR 2+ (1.54, P = 0.0039) and rMR ≥ 3+ (2.16, P = 0.011) were compared to rMR ≤ 1+. Moreover, patients with stable rMR ≤ 1+ grades within 12 months showed significantly higher survival rates compared to patients with rMR ≤ 1+ at discharge and rMR ≥ 2+ at 12-month follow-up or rMR ≥ 2+ at discharge and 12-month follow-up (P = 0.029).CONCLUSIONS: Patients with optimal and durable rMR ≤ 1+ at discharge and 12-month follow-up showed better outcome compared to patients with rMR 2+ and rMR ≥ 3+. Treatment success and durability characterized by rMR ≤ 1+ at discharge and 12 months seem to be important factors for long-term outcomes, which has to be further confirmed by prospective randomized trials.",
keywords = "Aged, Aged, 80 and over, Heart Failure, Heart Valve Prosthesis Implantation, Humans, Middle Aged, Mitral Valve/diagnostic imaging, Mitral Valve Insufficiency/epidemiology, Prospective Studies, Retrospective Studies, Treatment Outcome",
author = "Daniel Reichart and Daniel Kalbacher and Nicole R{\"u}bsamen and Eike Tigges and Christina Thomas and Johannes Schirmer and Hermann Reichenspurner and Stefan Blankenberg and Lenard Conradi and Ulrich Sch{\"a}fer and Edith Lubos",
note = "{\textcopyright} 2020 European Society of Cardiology.",
year = "2020",
month = oct,
doi = "10.1002/ejhf.1774",
language = "English",
volume = "22",
pages = "1840--1848",
journal = "EUR J HEART FAIL",
issn = "1388-9842",
publisher = "Oxford University Press",
number = "10",

}

RIS

TY - JOUR

T1 - The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation

AU - Reichart, Daniel

AU - Kalbacher, Daniel

AU - Rübsamen, Nicole

AU - Tigges, Eike

AU - Thomas, Christina

AU - Schirmer, Johannes

AU - Reichenspurner, Hermann

AU - Blankenberg, Stefan

AU - Conradi, Lenard

AU - Schäfer, Ulrich

AU - Lubos, Edith

N1 - © 2020 European Society of Cardiology.

PY - 2020/10

Y1 - 2020/10

N2 - AIMS: MitraClip therapy for the treatment of functional mitral regurgitation (FMR) is an increasingly used intervention for high-risk surgical patients. The aim of this observational study was to assess the impact of residual mitral regurgitation (rMR) at discharge on long-term outcome after MitraClip therapy in patients with FMR.METHODS AND RESULTS: Overall, 458 patients (mean age 73.8 ± 8.9 years) underwent MitraClip implantation between September 2008 and December 2017. The impact of rMR ≤ 1+ at discharge (n = 251) was retrospectively compared to patients graded as rMR 2+ (n = 173) and rMR ≥3+ (n = 34) at discharge. Median follow-up time was 5.09 years (5.00-5.26) with maximum follow-up of 10.02 years. The primary outcome was survival, and Kaplan-Meier analyses revealed significant differences among all rMR subgroups with highest survival rates for rMR ≤ 1+ patients. This was further confirmed by composite outcome analyses (P < 0.02). The inferior outcomes of rMR 2+ and rMR ≥ 3+ at discharge were confirmed by increased adjusted hazard ratios when rMR 2+ (1.54, P = 0.0039) and rMR ≥ 3+ (2.16, P = 0.011) were compared to rMR ≤ 1+. Moreover, patients with stable rMR ≤ 1+ grades within 12 months showed significantly higher survival rates compared to patients with rMR ≤ 1+ at discharge and rMR ≥ 2+ at 12-month follow-up or rMR ≥ 2+ at discharge and 12-month follow-up (P = 0.029).CONCLUSIONS: Patients with optimal and durable rMR ≤ 1+ at discharge and 12-month follow-up showed better outcome compared to patients with rMR 2+ and rMR ≥ 3+. Treatment success and durability characterized by rMR ≤ 1+ at discharge and 12 months seem to be important factors for long-term outcomes, which has to be further confirmed by prospective randomized trials.

AB - AIMS: MitraClip therapy for the treatment of functional mitral regurgitation (FMR) is an increasingly used intervention for high-risk surgical patients. The aim of this observational study was to assess the impact of residual mitral regurgitation (rMR) at discharge on long-term outcome after MitraClip therapy in patients with FMR.METHODS AND RESULTS: Overall, 458 patients (mean age 73.8 ± 8.9 years) underwent MitraClip implantation between September 2008 and December 2017. The impact of rMR ≤ 1+ at discharge (n = 251) was retrospectively compared to patients graded as rMR 2+ (n = 173) and rMR ≥3+ (n = 34) at discharge. Median follow-up time was 5.09 years (5.00-5.26) with maximum follow-up of 10.02 years. The primary outcome was survival, and Kaplan-Meier analyses revealed significant differences among all rMR subgroups with highest survival rates for rMR ≤ 1+ patients. This was further confirmed by composite outcome analyses (P < 0.02). The inferior outcomes of rMR 2+ and rMR ≥ 3+ at discharge were confirmed by increased adjusted hazard ratios when rMR 2+ (1.54, P = 0.0039) and rMR ≥ 3+ (2.16, P = 0.011) were compared to rMR ≤ 1+. Moreover, patients with stable rMR ≤ 1+ grades within 12 months showed significantly higher survival rates compared to patients with rMR ≤ 1+ at discharge and rMR ≥ 2+ at 12-month follow-up or rMR ≥ 2+ at discharge and 12-month follow-up (P = 0.029).CONCLUSIONS: Patients with optimal and durable rMR ≤ 1+ at discharge and 12-month follow-up showed better outcome compared to patients with rMR 2+ and rMR ≥ 3+. Treatment success and durability characterized by rMR ≤ 1+ at discharge and 12 months seem to be important factors for long-term outcomes, which has to be further confirmed by prospective randomized trials.

KW - Aged

KW - Aged, 80 and over

KW - Heart Failure

KW - Heart Valve Prosthesis Implantation

KW - Humans

KW - Middle Aged

KW - Mitral Valve/diagnostic imaging

KW - Mitral Valve Insufficiency/epidemiology

KW - Prospective Studies

KW - Retrospective Studies

KW - Treatment Outcome

U2 - 10.1002/ejhf.1774

DO - 10.1002/ejhf.1774

M3 - SCORING: Journal article

C2 - 32267056

VL - 22

SP - 1840

EP - 1848

JO - EUR J HEART FAIL

JF - EUR J HEART FAIL

SN - 1388-9842

IS - 10

ER -