D'ascenzo, Fabrizio, Moretti, Claudio, Marra, Walter Grosso, Montefusco, Antonio, Omede, Pierluigi, Taha, Salma, Castagno, Davide ORCID: 0000-0001-8491-152X, Gaemperli, Oliver, Taramasso, Maurizio, Frea, Simone, Pidello, Stefano, Rudolph, Volker, Franzen, Olaf, Braun, Daniel, Giannini, Cristina ORCID: 0000-0002-5472-6881, Ince, Huseyin, Perl, Leor, Zoccai, Giuseppe, Marra, Sebastiano, D'Amico, Maurizio, Maisano, Francesco ORCID: 0000-0002-3691-1709, Rinaldi, Mauro ORCID: 0000-0002-7092-8619 and Gaita, Fiorenzo (2015). Meta-Analysis of the Usefulness of Mitraclip in Patients With Functional Mitral Regurgitation. Am. J. Cardiol., 116 (2). S. 325 - 332. BRIDGEWATER: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC. ISSN 1879-1913

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Abstract

Midterm outcomes for patients presenting with heart failure and functional mitral regurgitation (MR) treated with Mitraclip remain unclear. Pubmed, Medline, and Google Scholar were systematically searched for studies enrolling patients with severe-moderate MR who underwent Mitraclip implantation. All events after at least 6 months were the primary safety end point (including death, rehospitalization for heart failure, and reinterventions), whereas change in the ejection fraction, left ventricular volumes, arterial pulmonary pressure, and left atrial diameters were considered as secondary end points. Meta-regression analysis was performed to evaluate the effect of baseline clinical and echocardiographic parameters on efficacy outcomes: 875 patients were included in 9 studies; 1.48 clips (1.3 to 1.7) for patients were implanted, and after a median follow-up of 9 months (6 to 12), 409 patients (78% [75% to 83%]) were in class New York Heart Association I/II and 57 (11% [8% to 14%]) still had moderate-to-severe MR. Overall adverse events occurred in 137 (26% [20% to 31%]) of the patients and 78(15% [1% to 17%]) of them died; 6-minute walk test improved by 100 m (83 to 111), whereas a significant reduction in left ventricular volumes and systolic pulmonary pressure was reported. At meta-regression analysis, an increase in left ventricle systolic volumes positively affected reduction of volumes after Mitraclip, whereas atrial fibrillation reduced the positive effect of the valve implantation on ejection fraction on end-diastolic and -systolic volumes. In conclusion, Mitraclip represents an efficacious strategy for patients with heart failure and severe MR. It offers a significant improvement in functional class and in cardiac remodeling, in patients with severely dilated hearts as well, although its efficacy remains limited in the presence of atrial fibrillation. (C) 2015 Elsevier Inc. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
D'ascenzo, FabrizioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moretti, ClaudioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marra, Walter GrossoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montefusco, AntonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Omede, PierluigiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Taha, SalmaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Castagno, DavideUNSPECIFIEDorcid.org/0000-0001-8491-152XUNSPECIFIED
Gaemperli, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Taramasso, MaurizioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frea, SimoneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pidello, StefanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudolph, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Franzen, OlafUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giannini, CristinaUNSPECIFIEDorcid.org/0000-0002-5472-6881UNSPECIFIED
Ince, HuseyinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perl, LeorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zoccai, GiuseppeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marra, SebastianoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
D'Amico, MaurizioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maisano, FrancescoUNSPECIFIEDorcid.org/0000-0002-3691-1709UNSPECIFIED
Rinaldi, MauroUNSPECIFIEDorcid.org/0000-0002-7092-8619UNSPECIFIED
Gaita, FiorenzoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-398803
DOI: 10.1016/j.amjcard.2015.04.025
Journal or Publication Title: Am. J. Cardiol.
Volume: 116
Number: 2
Page Range: S. 325 - 332
Date: 2015
Publisher: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Place of Publication: BRIDGEWATER
ISSN: 1879-1913
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TO-EDGE REPAIR; VALVE REPAIR; ATRIAL-FIBRILLATION; HEART-FAILURE; OUTCOMES; THERAPY; SURGERY; EXPERIENCE; REDUCTION; MODERATEMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/39880

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