Mitral valve interventions in heart failure

Lavall, Daniel; Hagendorff, Andreas; Schirmer, Stephan H.; Böhm, Michael; Borger, Michael A.; Laufs, Ulrich

doi:10.1002/ehf2.12287

Cited by 48 publications

(53 citation statements)

References 53 publications

(141 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Heart failure (HF) is a systemic disease afflicting up to 2% of the population worldwide [44,45]. Although it represents a major burden in terms of expenditure of socio-economic resources and costs [46], the successful accomplishments in diagnostics [47] and treatment [48][49][50] achieved in the last decades have led to an improvement in outcomes [51] and to an increased life expectancy [52]. Consequently, the number of older HF patients with increasing clinical complexity is progressively growing [53].…”

Section: Sarcopenia In Hfmentioning

confidence: 99%

Muscle Wasting and Sarcopenia in Heart Failure—The Current State of Science

Lena

Anker

Springer

2020

IJMS

View full text Add to dashboard Cite

Sarcopenia is primarily characterized by skeletal muscle disturbances such as loss of muscle mass, quality, strength, and physical performance. It is commonly seen in elderly patients with chronic diseases. The prevalence of sarcopenia in chronic heart failure (HF) patients amounts to up to 20% and may progress into cardiac cachexia. Muscle wasting is a strong predictor of frailty and reduced survival in HF patients. Despite many different techniques and clinical tests, there is still no broadly available gold standard for the diagnosis of sarcopenia. Resistance exercise and nutritional supplementation represent the currently most used strategies against wasting disorders. Ongoing research is investigating skeletal muscle mitochondrial dysfunction as a new possible target for pharmacological compounds. Novel agents such as synthetic ghrelin and selective androgen receptor modulators (SARMs) seem promising in counteracting muscle abnormalities but their effectiveness in HF patients has not been assessed yet. In the last decades, many advances have been accomplished but sarcopenia remains an underdiagnosed pathology and more efforts are needed to find an efficacious therapeutic plan. The purpose of this review is to illustrate the current knowledge in terms of pathogenesis, diagnosis, and treatment of sarcopenia in order to provide a better understanding of wasting disorders occurring in chronic heart failure.

show abstract

Section: Sarcopenia In Hfmentioning

confidence: 99%

Muscle Wasting and Sarcopenia in Heart Failure—The Current State of Science

Lena

Anker

Springer

2020

IJMS

View full text Add to dashboard Cite

show abstract

“…Selection or sampling bias towards moderate and mild FMR may have induced inaccurate quantification. [22][23][24][25][26][27][28] However, LV contractility parameters should only be determined in patients with regular sinus rhythm. 4,21 The more enlarged LV dimensions, the less reverse remodelling can be presumed after treatment.…”

Section: Attempted Explanation For the Conflicting Echocardiographic mentioning

confidence: 99%

“…To analyse LV remodelling and reverse LV remodelling after therapy in more detail, additional Echocardiographic assessment of functional mitral regurgitation parameters describing the LV geometry and LV function should be presented such as sphericity ratio and index, lateral and posterior dislocation of the papillary muscle, interpapillary muscle distance, tenting area and tethering angles, and LV contractility parameters such as peak power index and global longitudinal peak systolic strain. [22][23][24][25][26][27][28] However, LV contractility parameters should only be determined in patients with regular sinus rhythm. Both trials have not presented any of these assessments.…”

Section: Attempted Explanation For the Conflicting Echocardiographic mentioning

confidence: 99%

Echocardiographic assessment of functional mitral regurgitation: opening Pandora's box?

Hagendorff¹,

Doenst

Falk

2019

ESC Heart Failure

Self Cite

View full text Add to dashboard Cite

Two recent trials of transcatheter mitral‐valve repair in patients with functional mitral regurgitation (FMR) presented opposing results for the MitraClip® compared to medical therapy alone. The conflicting results gave rise to intensive discussions about assessment of mitral valve regurgitation (MR). A recent editorial viewpoint provided a potential explanation presenting a new pathophysiologic concept. However, the echocardiographic characterization of both trials' patients is inconsistent and the discussed concepts appear to suffer from plausibility weaknesses. It is well conceivable that limitations in the echocardiographic assessment of the trial patients introduced a bias regarding the selection of patients with severe (or less severe) MR that may be a more plausible explanation for the differences in outcome. We here illustrate our viewpoint regarding the two MitraClip trials and also illustrate the difficulties in assessing functional MR properly. It may indeed be “opening Pandora's box”, but we will also make an attempt to provide a solution.

show abstract

“…As mitral regurgitation (MR) inherently leads to left ventricular dilatation via increased filling pressures and refractory volume overload, chronic heart failure (CHF) is a common concomitant factor of patients referred for surgical mitral valve repair with significant impact on postprocedural outcome [ 1 , 2 , 3 , 4 ]. A well-known consequence of CHF is an increase in plasma volume triggering acute decompensation with a significant impact on the prognosis of these patients [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Subclinical Congestion on Outcome of Patients Undergoing Mitral Valve Surgery

et al. 2020

View full text Add to dashboard Cite

Since risk assessment prior to cardiac surgery is based on proven but partly unsatisfactory scores, the need for novel tools in preoperative risk assessment taking into account cardiac decompensation is obvious. Even subclinical chronic heart failure is accompanied by an increase in plasma volume. This increase is illustrated by means of a plasma volume score (PVS), calculated using weight, gender and hematocrit. A retrospective analysis of 187 consecutive patients with impaired left ventricular function undergoing mitral valve surgery at a single centre between 2013 and 2016 was conducted. Relative preoperative PVS was generated by subtracting the ideal from actual calculated plasma volume. The study population was divided into two cohorts using a relative PVS score > 3.1 as cut-off. Patients with PVS > 3.1 had a significantly higher need for reoperation for bleeding/tamponade (5.5% vs. 16.7%; p = 0.016) and other non-cardiac causes (9.4% vs. 21.7%; p = 0.022). In-hospital as well as 6-month, 1-year and 5-year mortality was significantly increased in PVS > 3.1 (6.3% vs. 18.3%; p = 0.013; 9.4% vs. 23.3%; p = 0.011; 11.5% vs. 23.3%; p = 0.026; 18.1% vs. 33.3%; p = 0.018). Elevated PVS above the defined cut-off used to quantify subclinical congestion was linked to significantly worse outcome after mitral valve surgery and therefore could be a useful addition to current preoperative risk stratification.

show abstract

Mitral valve interventions in heart failure

Cited by 48 publications

References 53 publications

Muscle Wasting and Sarcopenia in Heart Failure—The Current State of Science

Muscle Wasting and Sarcopenia in Heart Failure—The Current State of Science

Echocardiographic assessment of functional mitral regurgitation: opening Pandora's box?

Impact of Subclinical Congestion on Outcome of Patients Undergoing Mitral Valve Surgery

Contact Info

Product

Resources

About