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Left ventricular reverse remodelling predicts long-term outcomes in patients with functional mitral regurgitation undergoing MitraClip therapy: results from a multicentre registry.
- Source :
-
European Journal of Heart Failure . Feb2019, Vol. 21 Issue 2, p196-204. 9p. 4 Charts, 4 Graphs. - Publication Year :
- 2019
-
Abstract
- <bold>Aims: </bold>To explore whether left ventricular reverse remodelling (LVRR) is a predictor of outcomes in patients with functional mitral regurgitation (FMR) undergoing MitraClip procedure.<bold>Methods and Results: </bold>We analysed 184 consecutive patients with FMR who underwent successful MitraClip procedure. LVRR was defined as a reduction in left ventricular end-systolic volume ≥ 10% from baseline to 6 months. LVRR was observed in 79 (42.9%) patients. Compared with non-LVRR, LVRR patients were more likely to be females, less likely to have an ischaemic aetiology of mitral regurgitation or a prior (<6 months) heart failure (HF) hospitalization, and had smaller left ventricular dimensions. New York Heart Association class improved from baseline up to 1-year follow-up in both groups. Higher rates of overall survival (87.3% vs. 75.2%, P = 0.039), freedom from HF hospitalization (77.2% vs. 60%, P = 0.020), and freedom from the composite endpoint (cardiovascular mortality or HF hospitalization) (74.7% vs. 55.2%; P = 0.012) were observed in LVRR vs. non-LVRR patients at 2-year follow-up. LVRR was associated with a significant reduction of the adjusted relative risk of mortality, HF hospitalization and composite endpoint [hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.20-0.96, P = 0.040; HR 0.55; 95% CI 0.32-0.97, P = 0.038; and HR 0.54; 95% CI 0.32-0.92, P = 0.023, respectively]. Female gender, absence of diabetes, freedom from prior HF hospitalization, non-ischaemic aetiology of mitral regurgitation, and left ventricular end-diastolic diameter < 75 mm were found to be independent predictors of LVRR.<bold>Conclusions: </bold>Left ventricular reverse remodelling is associated with better long-term outcomes in patients with FMR successfully treated with MitraClip. A careful patient selection may be useful as specific baseline features predict favourable left ventricular remodelling. [Correction added on 17 January 2019, after online publication: the preceding sentence has been changed.]. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MITRAL valve insufficiency
*VENTRICULAR remodeling
*HEART failure
*ELECTRONIC publications
*LEFT heart ventricle
*COMPARATIVE studies
*ECHOCARDIOGRAPHY
*HEART physiology
*HEART ventricles
*PROSTHETIC heart valves
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*PROGNOSIS
*PROSTHETICS
*RESEARCH
*TIME
*EVALUATION research
*TREATMENT effectiveness
*ACQUISITION of data
*RETROSPECTIVE studies
Subjects
Details
- Language :
- English
- ISSN :
- 13889842
- Volume :
- 21
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- European Journal of Heart Failure
- Publication Type :
- Academic Journal
- Accession number :
- 134739104
- Full Text :
- https://doi.org/10.1002/ejhf.1343