Impact of heart failure severity on the mortality benefit of mitral transcatheter edge-to-edge valve repair.

Autor: Magni V; Division of Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.; Division of Cardiology, Ospedale di Desenzano, Desenzano, Italy., Adamo M; Division of Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. mariannaadamo@hotmail.com., Pezzola E; Division of Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Rubbio AP; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Giannini C; Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy., Masiero G; Interventional Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University of Padua, Padua, Italy., Grasso C; Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy., Denti P; Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy., Giordano A; Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy., De Marco F; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Bartorelli AL; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Montorfano M; Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute, Milan, Italy., Godino C; Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute, Milan, Italy., Baldi C; Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, 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; Cardiac Surgery Unit Poliambulanza Hospital, Fondazione Poliambulanza, Brescia, Italy., Crimi G; Cardiac Catheterization Laboratory, Policlinico San Martino, Genoa, Italy.; Cardiac Catheterization Laboratory, Policlinico San Matteo, Pavia, Italy., Tusa M; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Testa L; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Serafini L; Division of Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Cani D; Division of Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Guarini G; Division of Cardiology, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy., Huqi A; Division of Cardiology, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy., Sesana M; Division of Cardiology, Ospedale di Desenzano, Desenzano, Italy., De Carlo M; Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy., Maisano F; Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy., Tarantini G; Interventional Cardiology Unit, Department of Cardiac, Thoracic and Vascular Science, University of Padua, Padua, Italy., Tamburino C; Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy., Bedogni F; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Metra M; Division of Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Jazyk: angličtina
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2024 Jul 24. Date of Electronic Publication: 2024 Jul 24.
DOI: 10.1007/s00392-024-02490-7
Abstrakt: Background: To assess the interaction between heart failure (HF) severity and optimal reduction of secondary mitral regurgitation (SMR) on mortality in patients undergoing transcatheter edge-to-edge repair (M-TEER).
Methods and Results: Among 1656 patients included in the Italian Society of Interventional Cardiology (GIse) registry Of Transcatheter treatment of mitral valve regurgitaTiOn (GIOTTO) 984 had SMR and complete data on advanced HF. Advanced HF was defined as NYHA class III or IV, left ventricular ejection fraction ≤ 30%, and > 1 HF hospitalization during the last 12 months. Optimal M-TEER was defined as residual SMR ≤ 1 + at discharge. One hundred sixteen patients (11.8%) had advanced HF. Achievement of an optimal SMR reduction was similar in patients with and without advanced HF (65% and 60% respectively). Advanced HF was an independent predictor of 2-year all-cause death (adjusted HR 1.52, 95% CI 1.09-2.10). Optimal M-TEER, as compared to a no-optimal M-TEER, was associated with a reduced risk of death both in patients with advanced (HR 0.55, 95% CI 0.32-0.97; p = 0.039) and no-advanced HF (HR 0.59, 95% CI 0.46-0.78; p < 0.001; p = 0.778 for interaction).
Conclusions: Advanced HF is associated with poor outcome in patients undergoing M-TEER. However, an optimal SMR reduction reduces the risk of 2-year mortality regardless of HF severity.
(© 2024. The Author(s).)
Databáze: MEDLINE
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