Association between echocardiographic velocity time integral ratio of mitral valve and left ventricular outflow tract and clinical outcomes post transcatheter edge-to-edge mitral valve repair.

Autor: Scalia IG; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Farina JM; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Wraith R; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Brown L; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Abbas MT; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Pereyra M; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Allam M; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Mahmoud AK; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Kamel MA; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Barry T; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Fortuin FD; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Lester SJ; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Sweeney J; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Sell-Dottin KA; Department of Cardiothoracic Surgery, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Alkhouli M; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. SW, Rochester, MN, 55901, USA., Holmes DR; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. SW, Rochester, MN, 55901, USA., Chao CJ; Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. SW, Rochester, MN, 55901, USA., Alsidawi S; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Ayoub C; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA., Arsanjani R; Department of Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA.
Jazyk: angličtina
Zdroj: Heliyon [Heliyon] 2024 Jun 05; Vol. 10 (11), pp. e32378. Date of Electronic Publication: 2024 Jun 05 (Print Publication: 2024).
DOI: 10.1016/j.heliyon.2024.e32378
Abstrakt: Background: Residual mitral regurgitation (MR) is frequent after transcatheter edge-to-edge repair (TEER). There is controversy regarding the clinical impact of residual MR and its quantitative assessment by transthoracic echocardiography (TTE), which is often challenging with multiple eccentric jets and artifact from the clip. The utility of the velocity time integral (VTI) ratio between the mitral valve (MV) and left ventricular outflow tract (LVOT), (VTI MV/LVOT ), a simple Doppler measurement that increases with MR, has not been assessed post TEER.
Methods: Baseline characteristics, clinical outcomes, and TTE data from patients who underwent TEER between 2014 and 2021 across three academic centers were retrospectively analyzed. Post-procedure TTEs were evaluated for VTI MV/LVOT in the first three months after TEER. One-year outcomes including all-cause and cardiac mortality, major adverse cardiac events, and MV reintervention were compared between patients with high VTI MV/LVOT (≥2.5) and low (<2.5).
Results: In total, 372 patients were included (mean age 78.7 ± 8.8 years, 68 % male, mean pre-TEER ejection fraction of 50.5 ± 14.7 %). Follow up TTEs were performed at a median of 37.5 (IQR 30-48) days post-procedure. Patients with high VTI MV/LVOT had significantly higher all-cause mortality (HR 2.10, p = 0.003), cardiac mortality (HR 3.03, p = 0.004) and heart failure admissions (HR 2.28, p < 0.001) at one-year post-procedure. There was no association between raised VTI MV/LVOT and subsequent MV reintervention.
Conclusion: High VTI MV/LVOT has clinically significant prognostic value at one year post TEER. This tool could be used to select patients for consideration of repeat intervention.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2024 The Authors. Published by Elsevier Ltd.)
Databáze: MEDLINE
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