Universität zu Köln

Tanaka, Tetsu ORCID: 0000-0003-0780-8689, Kavsur, Refik, Spieker, Maximilian, Iliadis, Christos, Metze, Clemens, Horn, Patrick, Sugiura, Atsushi, Baldus, Stephan, Kelm, Malte, Nickenig, Georg, Pfister, Roman, Westenfeld, Ralf and Becher, Marc Ulrich (2021). Prognostic value of hepatorenal function following transcatheter edge-to-edge mitral valve repair. Clin. Res. Cardiol., 110 (12). S. 1947 - 1957. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Background Hepatorenal dysfunction is a strong prognostic predictor in patients with heart failure. However, the prognostic impact of the hepatorenal dysfunction in patients undergoing transcatheter mitral valve repair (TMVR) has not been well studied. Methods In consecutive patients who underwent edge-to-edge TMVR at three German centers, the model for end-stage liver disease excluding international normalized ratio (MELD-XI) score was calculated as 5.11 x ln [serum total bilirubin (mg/dl)] + 11.76 x ln [serum creatinine (mg/dl)] + 9.44. Patients were stratified into high (> 11) or low (<= 11) MELD-XI score of which an incidence of the composite outcome, consisting of all-cause mortality and heart failure hospitalization, within 2 years after TMVR was assessed. Results Of the 881 patients, the mean MELD-XI score was 11.0 +/- 5.9, and 415 patients (47.1%) had high MELD-XI score. The MELD-XI score was correlated with male, effective regurgitant orifice area, and tricuspid regurgitation severity and inversely related to left ventricular ejection fraction. Patients with high MELD-XI score had a higher incidence of the composite outcome than those with low MELD-XI score (47.7% vs. 29.8%; p < 0.0001), and in multivariable analysis, the high MELD-XI score was an independent predictor of the composite outcome [adjusted hazard ratio (HR) 1.34; 95% confidence interval (CI) 1.02-1.77; p = 0.04). Additionally, the MELD-XI score as a continuous variable was also an independent predictor (adjusted HR 1.02; 95% CI 1.00-1.05; p = 0.048). Conclusions The MELD-XI score was associated with clinical outcomes within 2 years after TMVR and can be a useful risk-stratification tool in patients undergoing TMVR.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Tanaka, Tetsu UNSPECIFIED orcid.org/0000-0003-0780-8689 UNSPECIFIED Kavsur, Refik UNSPECIFIED UNSPECIFIED UNSPECIFIED Spieker, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Metze, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Sugiura, Atsushi UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kelm, Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Westenfeld, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Becher, Marc Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-582242
DOI:	10.1007/s00392-021-01908-w
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	110
Number:	12
Page Range:	S. 1947 - 1957
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SCORING SYSTEM; HEART-FAILURE; DYSFUNCTION; STRATEGIES; SOCIETY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58224