Pulmonary artery pressures and outcomes after MitraClip.

Autor: Rashi Y; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Haberman D; Heart Center, Kaplan Medical Center, Hebrew University, Jerusalem, Israel., Tonchev I; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Peretz A; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Medvedovsky AT; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Gotsman I; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Minha S; Cardiology Department, Shamir Medical Center (Assaf-Harofeh Campus), Zeriffin, Israel., Poles L; Heart Center, Kaplan Medical Center, Hebrew University, Jerusalem, Israel., Shimoni S; Heart Center, Kaplan Medical Center, Hebrew University, Jerusalem, Israel., Goland S; Heart Center, Kaplan Medical Center, Hebrew University, Jerusalem, Israel., Perlman GY; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Danenberg HD; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Beeri R; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Shuvy M; Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Jazyk: angličtina
Zdroj: ESC heart failure [ESC Heart Fail] 2020 Dec; Vol. 7 (6), pp. 4071-4079. Date of Electronic Publication: 2020 Oct 21.
DOI: 10.1002/ehf2.13018
Abstrakt: Aims: We evaluated the impact of MitraClip on systolic pulmonary artery pressure (sPAP) and the effects of baseline sPAP on outcomes.
Methods and Results: In a cohort of patients who underwent MitraClip implantation, three groups were defined according to pre-procedure sPAP levels. Clinical and echocardiographic data were compared. The study included 177 patients: 59 had severe pulmonary hypertension (PHT), 96 had mild to moderate PHT, and 22 had no PHT. In patients with pre-existing severe PHT, sPAP was reduced from 70.8 ± 9.2 to 56.8 ± 13.7 mmHg (P < 0.001), sPAP remained unchanged in patients with mild to moderate PHT but was significantly increased from 30.8 ± 4.3 to 38.6 ± 8.3 mmHg in the no-PHT group (P < 0.001). Improvement of sPAP was observed in 77% of severe PHT group, while worsening of sPAP was more common among patients with no-PHT [57% compared with 33% among the mild to moderate PHT and 7% in the severe PHT group, respectively, (P < 0.001)]. One year survival was similar among the study groups.
Conclusions: MitraClip decreases PHT among patients with severe PHT. A concerning finding is that most patients with no-PHT increase their sPAP.
(© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)
Databáze: MEDLINE
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