630 Impact of right ventricular dysfunction after mitraclip treatment as a bridge to heart transplantation: insight from the mitrabridge strategy
| Autor: | Andrea Raffaele Munafò, Andrea Scotti, Rodrigo Estevez-loureiro, Dabit Arzamendi, Neil P. Fam, Diego Maffeo, Marianna Adamo, Jf Ooms, Luciano Potena, Anna Sonia Petronio, Carmelo Grasso, Fabien Praz, Claudia Raineri, Gabriele Crimi, Francesco Saia, Cosmo Godino |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | European Heart Journal Supplements. 23 |
| ISSN: | 1554-2815 1520-765X |
| DOI: | 10.1093/eurheartj/suab139.033 |
| Popis: | Aims MitraClip treatment has been recently proposed as a ‘bridge strategy’ solution for advanced heart failure (HF) patients with significant functional mitral regurgitation (MR), who are potential candidates or are waiting for cardiac replacement therapy (LVAD or heart transplantation, HTx). In this clinical scenario, left-ventricular-related right ventricular dysfunction (RVD) represents an important prognostic factor. Our study aimed to investigate the possible prognostic implication of RVD in advanced HF patients treated with MitraClip as a bridge to HTx strategy. Methods and results RVD was assessed using the relationship between tricuspid annular peak systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP). All patients from the MitraBridge registry for whom these two echocardiographic parameters were available, were included in the study. A cut-off value of TAPSE/PASP ratio < 0.36 was used to defined RVD, as previously reported. The primary outcome was a composite Endpoint of all-cause death or rehospitalization for HF at 2-year. For patients who underwent LVAD implantation or HTx, follow-up data were censored at the time of those events. A total of 80 patients were included in the study. The median TAPSE/PASP ratio was 0.35 (25th–75th: 0.27–0.46), with 43 (54%) patients having a TAPSE/PASP ratio < 0.36 (RVD group). The latter had a prevalent MR ischaemic etiology (49% vs. 38%), with a more frequent history of percutaneous coronary intervention (46.5% vs. 22%, P = 0.02). Except for TAPSE (15.7 ± 3.6 mm vs. 19.2 ± 3.7 mm, P = 0.001) and PASP (61 ± 14 mmHg vs. 39.5 ± 9.5 mmHg, P Conclusions In advanced HF patients with functional MR, MitraClip treatment could prevent or ameliorate left-ventricular-related RVD, allowing safe access to HTx or LVAD. |
| Databáze: | OpenAIRE |
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