Universität zu Köln

Patzelt, Johannes, Zhang, Wenzhong, Sauter, Reinhard, Mezger, Matthias, Nording, Henry, Ulrich, Miriam, Becker, Annika, Patzelt, Tara, Rudolph, Volker, Eitel, Ingo, Saad, Mohammed, Bamberg, Fabian, Schlensak, Christian, Gawaz, Meinrad, Boekstegers, Peter, Schreieck, Juergen, Seizer, Peter and Langer, Harald F. (2019). Elevated Mitral Valve Pressure Gradient Is Predictive of Long-Term Outcome After Percutaneous Edge-to-Edge Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation (MR), But Not in Functional MR. J. Am. Heart Assoc., 8 (13). HOBOKEN: WILEY. ISSN 2047-9980

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Abstract

Background-This study analyzed the effects on long-term outcome of residual mitral regurgitation (MR) and mean mitral valve pressure gradient (MVPG) after percutaneous edge-to-edge mitral valve repair using the MitraClip system. Methods and Results-Two hundred fifty-five patients who underwent percutaneous edge-to-edge mitral valve repair were analyzed. Kaplan-Meier and Cox regression analyses were performed to evaluate the impact of residual MR and MVPG on clinical outcome. A combined clinical end point (all-cause mortality, MV surgery, redo procedure, implantation of a left ventricular assist device) was used. After percutaneous edge-to-edge mitral valve repair, mean MVPG increased from 1.6 +/- 1.0 to 3.1 +/- 1.5 mm Hg (P<0.001). Reduction of MR severity to <= 2+ postintervention was achieved in 98.4% of all patients. In the overall patient cohort, residual MR was predictive of the combined end point while elevated MVPG >4.4 mm Hg was not according to Kaplan-Meier and Cox regression analyses. We then analyzed the cohort with degenerative and that with functional MR separately to account for these different entities. In the cohort with degenerative MR, elevated MVPG was associated with increased occurrence of the primary end point, whereas this was not observed in the cohort with functional MR. Conclusions-MVPG >4.4 mm Hg after MitraClip implantation was predictive of clinical outcome in the patient cohort with degenerative MR. In the patient cohort with functional MR, MVPG >4.4 mm Hg was not associated with increased clinical events.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Patzelt, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Zhang, Wenzhong UNSPECIFIED UNSPECIFIED UNSPECIFIED Sauter, Reinhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Mezger, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Nording, Henry UNSPECIFIED UNSPECIFIED UNSPECIFIED Ulrich, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Patzelt, Tara UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Eitel, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Saad, Mohammed UNSPECIFIED UNSPECIFIED UNSPECIFIED Bamberg, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlensak, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Gawaz, Meinrad UNSPECIFIED UNSPECIFIED UNSPECIFIED Boekstegers, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Schreieck, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Seizer, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Langer, Harald F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-135626
DOI:	10.1161/JAHA.118.011366
Journal or Publication Title:	J. Am. Heart Assoc.
Volume:	8
Number:	13
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	2047-9980
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ECHOCARDIOGRAPHY; IMPLANTATION; ANNULOPLASTY; SEVERITY; SURGERY; RISK Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13562