Doldi, Philipp M., Stolz, Lukas, Kalbacher, Daniel, Koell, Benedikt, Geyer, Martin, Ludwig, Sebastian, Orban, Mathias, Braun, Daniel, Weckbach, Ludwig T., Stocker, Thomas J., Naebauer, Michael, Higuchi, Satoshi ORCID: 0000-0002-7914-8256, Ruf, Tobias, Da Rocha e Silva, Jaqueline, Wild, Mirjam, Tence, Noemie, Unterhuber, Matthias, Schofer, Niklas, Petrescu, Aniela, Thiele, Holger, Lurz, Philipp, Lubos, Edith, von Bardeleben, Stephan, Karam, Nicole ORCID: 0000-0002-3861-6914, Samim, Daryoush ORCID: 0000-0002-0698-4456, Paradis, Jean-Michel, Iliadis, Christos, Xhepa, Erion ORCID: 0000-0002-0728-2819, Hagl, Christian, Massberg, Steffen and Hausleiter, Joerg (2022). Right ventricular dysfunction predicts outcome after transcatheter mitral valve repair for primary mitral valve regurgitation. Eur. J. Heart Fail., 24 (11). S. 2162 - 2172. HOBOKEN: WILEY. ISSN 1879-0844

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Abstract

Aims Right ventricular dysfunction (RVD), as expressed by right ventricular to pulmonary artery coupling, has recently been identified as a strong outcome predictor in patients undergoing mitral valve edge-to-edge repair (M-TEER) for secondary mitral regurgitation (MR). The aim of this study was to define RVD in patients undergoing M-TEER for primary MR (PMR) and to evaluate its impact on procedural MR reduction, symptomatic development and 2-year all-cause mortality. Methods and results This multicentre study included patients undergoing M-TEER for symptomatic PMR at nine international centres. The study cohort was divided into a derivation (DC) and validation cohort (VC) for calculation and validation of the best discriminatory value for RVD. A total of 648 PMR patients were included in the study. DC and VC were comparable regarding procedural success and outcomes at follow-up. Sensitivity analysis identified RVD as an independent predictor for 2-year mortality in the DC (hazard ratio [HR] 2.37, 95% confidence interval [CI] 1.47- 3.81, p < 0.001), which was confirmed in the VC (HR 2.06, 95% CI 1.36-3.13, p < 0.001). Procedural success (MR <= 2+) and symptomatic improvement at follow-up (New York Heart Association [NYHA] class <= II) were lower in PMR patients with RVD (MR <= 2+: 82% vs. 93%, p = 0.002; NYHA class <= II: 57.3% vs. 66.5%, p = 0.09 for with vs. without RVD). In all PMR patients, the presence of RVD significantly impaired 2-year survival after M-TEER (HR 2.23, 95% CI 1.63-3.05, p < 0.001). Conclusions Mitral valve edge-to-edge repair is an effective treatment option for PMR patients. The presence of RVD is associated with less MR reduction, less symptomatic improvement and increased 2-year mortality. Accordingly, RVD might be included into pre-procedural prognostic considerations. [GRAPHICS] .

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Doldi, Philipp M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stolz, LukasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kalbacher, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koell, BenediktUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Geyer, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ludwig, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Orban, MathiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weckbach, Ludwig T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stocker, Thomas J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Naebauer, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Higuchi, SatoshiUNSPECIFIEDorcid.org/0000-0002-7914-8256UNSPECIFIED
Ruf, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Da Rocha e Silva, JaquelineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wild, MirjamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tence, NoemieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Unterhuber, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schofer, NiklasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petrescu, AnielaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thiele, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lurz, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lubos, EdithUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Bardeleben, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karam, NicoleUNSPECIFIEDorcid.org/0000-0002-3861-6914UNSPECIFIED
Samim, DaryoushUNSPECIFIEDorcid.org/0000-0002-0698-4456UNSPECIFIED
Paradis, Jean-MichelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Iliadis, ChristosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Xhepa, ErionUNSPECIFIEDorcid.org/0000-0002-0728-2819UNSPECIFIED
Hagl, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Massberg, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hausleiter, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-694582
DOI: 10.1002/ejhf.2661
Journal or Publication Title: Eur. J. Heart Fail.
Volume: 24
Number: 11
Page Range: S. 2162 - 2172
Date: 2022
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1879-0844
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
QUALITY-OF-LIFE; TO-EDGE REPAIR; PERCUTANEOUS REPAIR; HEART-FAILURE; PULMONARY-CIRCULATION; EUROPEAN ASSOCIATION; CONTRACTILE FUNCTION; FUNCTIONAL STATUS; ECHOCARDIOGRAPHY; SURGERYMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69458

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