Impact of extra-mitral valve cardiac involvement in patients with primary mitral regurgitation undergoing transcatheter edge-to-edge repair.

Autor:	Popolo Rubbio A; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Sisinni A; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Moroni A; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Adamo M; Cardiac Catheterisation Laboratory and Cardiology, ASST Spedali Civili di Brescia, Brescia, Italy and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Grasso C; Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), AOU Policlinico 'G. Rodolico - S. Marco', University of Catania, Catania, Italy., Casenghi M; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Tusa MB; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Barletta M; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Denti P; Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy., Giordano A; Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy., De Marco F; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Bartorelli AL; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy., Montorfano M; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy and Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy., Godino C; Cardiology Unit, Heart Valve Center, San Raffaele Hospital IRCCS, Milan, Italy., Agricola E; Cardiovascular Imaging Unit Cardio-Thoracic-Vascular Department, Vita-Salute University, San Raffaele Hospital, IRCCS, Milan, Italy., Citro R; University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy.; Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy., De Felice F; Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy., Mongiardo A; Division of Cardiology, University Magna Graecia, Catanzaro, Italy., Monteforte I; AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy., Villa E; Valve Center, Poliambulanza Foundation Hospital, Brescia, Italy., Petronio AS; Cardiac Catheterisation Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy., Giannini C; Cardiac Catheterisation Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy., Crimi G; Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Masiero G; Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit, University of Padua, Padua, Italy., Tarantini G; Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit, University of Padua, Padua, Italy., Testa L; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Tamburino C; Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), AOU Policlinico 'G. Rodolico - S. Marco', University of Catania, Catania, Italy., Bedogni F; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Giotto Registry OBOT
Jazyk:	angličtina
Zdroj:	EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2023 Dec 18; Vol. 19 (11), pp. e926-e936. Date of Electronic Publication: 2023 Dec 18.
DOI:	10.4244/EIJ-D-23-00548
Abstrakt:	Background: In the context of primary mitral regurgitation (PMR), the selection of patients for transcatheter edge-to-edge repair (TEER) does not include a systematic assessment of PMR-associated cardiac remodelling. Aims: We aimed to investigate the epidemiology and prognostic significance of different phenotypes of extra-mitral valve (MV) cardiac involvement in a large series of patients with PMR referred for TEER. Methods: The study included 654 patients from the multicentre Italian GIOTTO registry, stratified into groups according to extra-mitral valve (MV) cardiac involvement. The primary endpoint was all-cause death at 2-year follow-up. Results: Patients with no cardiac involvement (NI; n=58), left heart involvement (LHI; n=343) and right heart involvement (RHI; n=253) were analysed. Acute technical success was achieved in 98% of patients. Kaplan-Meier curve analysis revealed significantly worse survival in patients with LHI and RHI (p=0.041). On multivariate Cox regression analysis, extra-MV cardiac involvement, haemoglobin level and technical success were independent predictors of the primary endpoint occurrence. Conclusions: Grading cardiac involvement may help refine risk stratification, since at least 1 group of extra-MV cardiac involvement represents in itself a negative predictor of midterm outcome.
Databáze:	MEDLINE
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