Left Ventricular Size Predicts Clinical Benefit After Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Regression Analysis

Zimarino, Marco; Ricci, Fabrizio; Capodanno, Davide; Innocentiis, Carlo De; Verrengia, Elvira; Swaans, Martin J.; Lombardi, Carlo; Brouwer, Jorn; Gallina, Sabina; Grasso, Carmelo; Caterina, Raffaele De; Tamburino, Corrado

doi:10.1016/j.carrev.2019.11.003

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…A robust predictive value of LV dimension for the functional outcome of patients has also been reported in surgical studies 22 – 24 . Recently, Zimarino and colleagues 25 performed a meta-analysis of 2 RCTs and 7 non-randomized observational studies. They reported by means of a meta-regression analysis that larger left ventricular end-diastolic volume index (LVEDVi) is closely related to a higher risk of all-cause mortality, CV mortality and cardiac-related hospitalization after PMVR.…”

Section: Discussionmentioning

confidence: 99%

Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

Polimeni

Albanese

Salerno

et al. 2020

Sci Rep

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Percutaneous mitral valve repair has been increasingly performed worldwide after approval. We sought to investigate predictors of clinical outcome in patients with mitral regurgitation undergoing percutaneous valve repair. The MITRA-UMG study, a single-centre registry, retrospectively collected consecutive patients with symptomatic moderate-to-severe or severe MR undergoing MitraClip therapy. The primary endpoint was the composite of cardiovascular death or rehospitalization for heart failure. Between March 2012 and July 2018, a total of 150 consecutive patients admitted to our institution were included. Procedural success was obtained in 95.3% of patients. The composite primary endpoint of cardiovascular death or rehospitalization for HF was met in 55 patients (37.9%) with cumulative incidences of 7.6%, 26.2%, at 30 days and 1-year, respectively. In the Cox multivariate model, NYHA functional class and left ventricular end-diastolic volume index (LVEDVi), independently increased the risk of the primary endpoint at long-term follow-up. At Kaplan–Meier analysis, a LVEDVi > 92 ml/m2 was associated with an increased incidence of the primary endpoint. In this study, patients presenting with dilated ventricles (LVEDVi > 92 ml/m2) and advanced heart failure symptoms (NYHA IV) at baseline carried the worst prognosis after percutaneous mitral valve repair.

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Section: Discussionmentioning

confidence: 99%

Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

Polimeni

Albanese

Salerno

et al. 2020

Sci Rep

View full text Add to dashboard Cite

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“…Two later meta-analyses (62,63), documented a significant reduction in mortality and risk of HF hospitalization among patients who received MitraClip+OMT as compared with OMT in secondary MR. The prognostic efficacy of PMVR seems to be a function of time, with mortality rates continuously diverging over a longer follow-up period (62).…”

Section: Percutaneous Edge-to-edge Mitral Valve Repairmentioning

confidence: 99%

Selection of the Optimal Candidate to MitraClip for Secondary Mitral Regurgitation: Beyond Mitral Valve Morphology

Salvatore

Ricci

Dangas

et al. 2021

Front. Cardiovasc. Med.

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Secondary mitral regurgitation (MR) occurs despite structurally normal valve apparatus due to an underlying disease of the myocardium leading to disruption of the balance between tethering and closing forces with ensuing failure of leaflet coaptation. In patients with heart failure (HF) and left ventricular dysfunction, secondary MR is independently associated with poor outcome, yet prognostic benefits related to the correction of MR have remained elusive. Surgery is not recommended for the correction of secondary MR outside coronary artery bypass grafting. Percutaneous mitral valve repair (PMVR) with MitraClip implantation has recently evolved as a new transcatheter treatment option of inoperable or high-risk patients with severe MR, with promising results supporting the extension of guideline recommendations. MitraClip is highly effective in reducing secondary MR in HF patients. However, the derived clinical benefit is still controversial as two randomized trials directly comparing PMVR vs. optimal medical therapy in severe secondary MR yielded virtually opposite conclusions. We reviewed current evidence to identify predictors of PMVR-related outcomes in secondary MR useful to improve the timing and the selection of patients who would derive maximal benefit from MitraClip intervention. Beyond mitral valve anatomy, optimal candidate selection should rely on a comprehensive diagnostic workup and a fine-tuned risk stratification process aimed at (i) recognizing the substantial heterogeneity of secondary MR and its complex interaction with the myocardium, (ii) foreseeing hemodynamic consequences of PMVR, (iii) anticipating futility and (iv) improving symptoms, quality of life and overall survival.

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Heart Failure with Reduced Ejection Fraction

Rao

Sabe

2022

Handbook of Outpatient Cardiology

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Left Ventricular Size Predicts Clinical Benefit After Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Regression Analysis

Cited by 5 publications

References 25 publications

Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

Selection of the Optimal Candidate to MitraClip for Secondary Mitral Regurgitation: Beyond Mitral Valve Morphology

Heart Failure with Reduced Ejection Fraction

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