12
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Effect of Atrial Fibrillation and Mitral Valve Gradients on Response to Percutaneous Mitral Valve Repair With the MitraClip System.

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Both pre-existing atrial fibrillation (AF) and mitral valve pressure gradients (MVPG) created by MitraClip implantation have demonstrated predictive power for unfavorable outcomes. Therefore, we aimed to assess the impact of MVPG following MitraClip on outcomes in patients with and without AF. A total of 200 patients who underwent MitraClip implantation in our institution were enrolled. Echocardiography was obtained before and after the procedure. The primary endpoint of the study was all-cause mortality 1-year after MitraClip implantation. Secondary end points were clinical improvements in NYHA functional class and reduction in MR severity after MitraClip implantation. Two hundred patients (74 ± 10 years, left ventricular ejection fraction 41% ± 14%, logistic EuroSCORE I 21 ± 15) were enrolled into the final analysis. One hundred twelve patients (56%) had pre-existing AF. One-year all-cause mortality was 17% without any differences between patients with or without pre-existing AF. Comparing postprocedural MVPG of surviving and deceased patients, deceased patients with pre-existing AF exhibited significantly elevated postprocedural MVPG compared with surviving patients without AF (4.8 ± 2.1 mm Hg vs 3.6 ± 1.8 mm Hg; p = 0.010). ROC analysis and Kaplan-Meier survival curves identified significantly reduced survival in AF patients with postprocedural MVPG above 4.0 mm Hg (p = 0.011). After MitraClip, a MVPG above 4.0 mm Hg in patients with pre-existing AF was a significant outcome predictor in univariate and multivariate analysis. In conclusion, we identified a high-risk cohort characterized by postprocedural MVPG above 4.0 mm Hg and pre-existing AF predicting poor long-term outcome.

          Related collections

          Author and article information

          Journal
          Am J Cardiol
          The American journal of cardiology
          Elsevier BV
          1879-1913
          0002-9149
          October 15 2018
          : 122
          : 8
          Affiliations
          [1 ] Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Düsseldorf, Germany.
          [2 ] UhlandPraxen-Praxisgemeinschaft Düsseldorf, Düsseldorf, Germany.
          [3 ] Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Düsseldorf, Germany; CARID (Cardiovascular Research Institute Düsseldorf), Düsseldorf, Germany.
          [4 ] Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Düsseldorf, Germany. Electronic address: Ralf.Westenfeld@med.uni-duesseldorf.de.
          Article
          S0002-9149(18)31417-6
          10.1016/j.amjcard.2018.06.050
          30103906
          12f77b72-419e-4dec-929f-bf6f813e2295
          History

          Comments

          Comment on this article