Universität zu Köln

Doldi, Philipp, Stolz, Lukas, Orban, Mathias ORCID: 0000-0001-7846-8808, Karam, Nicole ORCID: 0000-0002-3861-6914, Praz, Fabien, Kalbacher, Daniel, Lubos, Edith, Braun, Daniel, Adamo, Marianna, Giannini, Cristina, Melica, Bruno, Naebauer, Michael, Higuchi, Satoshi ORCID: 0000-0002-7914-8256, Wild, Mirjam, Neuss, Michael, Butter, Christian, Kassar, Mohammad ORCID: 0000-0002-7576-2224, Petrescu, Aniela, Pfister, Roman, Iliadis, Christos, Unterhuber, Matthias ORCID: 0000-0002-8175-276X, Thiele, Holger, Baldus, Stephan, von Bardeleben, Ralph Stephan, Schofer, Niklas, Hagl, Christian, Petronio, Anna Sonia, Massberg, Steffen, Windecker, Stephan, Lurz, Philipp, Metra, Marco and Hausleiter, Joerg (2022). Transcatheter Mitral Valve Repair in Patients With Atrial Functional Mitral Regurgitation. JACC-Cardiovasc. Imag., 15 (11). S. 1843 - 1852. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-7591

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Abstract

BACKGROUND Among patients with severe functional mitral regurgitation (FMR), atrial functional mitral regurgitation (aFMR) represents an underrecognized entity. Data regarding outcomes after mitral valve transcatheter edge-to-edge repair (M-TEER) in aFMR remain scarce. OBJECTIVES The objective of this study was to analyze the outcome of aFMR patients undergoing M-TEER. METHODS Using patients from the international EuroSMR (European Registry of Transcatheter Repair for Secondary Mitral Regurgitation) registry undergoing M-TEER for FMR, the authors analyzed baseline characteristics and 2-year outcomes in aFMR in comparison to non-aFMR and ventricular FMR. Additionally, the impact of right ventricular dysfunction (RVD) (defined as right ventricular to pulmonary artery uncoupling) on outcome after M-TEER was assessed. RESULTS Among 1,608 FMR patients treated by M-TEER, 126 (7.8%) were categorized as aFMR. All 126 aFMR patients had preserved left ventricular function without regional wall motion abnormalities, left arterial dilatation and Carpentier leaflet motion type I. Procedural success (defined as mitral regurgitation #2thorn at discharge) was 87.2% (P < 0.001) and New York Heart Association (NYHA) functional class significantly improved during follow-up (NYHA functional class III/IV: 86.5% at baseline to 36.6% at follow-up; P< 0.001). The estimated 2-year survival rate in aFMR patients was 70.4%. Twoyear survival did not differ significantly between aFMR, non-aFMR, and ventricular FMR. Besides NYHA functional class IV, RVD was identified as a strong independent predictor for 2-year survival (HR: 2.82 [95% CI: 1.24-6.45]; P = 0.014). CONCLUSIONS aFMR is a frequent cause of FMR and can be effectively treated with M-TEER to improve symptoms at follow-up. Advanced heart failure symptoms and RVD were identified as important risk factors for survival in aFMR patients. (J Am Coll Cardiol Img 2022;15:1843-1851) (c) 2022 by the American College of Cardiology Foundation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Doldi, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Stolz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Orban, Mathias UNSPECIFIED orcid.org/0000-0001-7846-8808 UNSPECIFIED Karam, Nicole UNSPECIFIED orcid.org/0000-0002-3861-6914 UNSPECIFIED Praz, Fabien UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalbacher, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Lubos, Edith UNSPECIFIED UNSPECIFIED UNSPECIFIED Braun, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Adamo, Marianna UNSPECIFIED UNSPECIFIED UNSPECIFIED Giannini, Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Melica, Bruno UNSPECIFIED UNSPECIFIED UNSPECIFIED Naebauer, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Higuchi, Satoshi UNSPECIFIED orcid.org/0000-0002-7914-8256 UNSPECIFIED Wild, Mirjam UNSPECIFIED UNSPECIFIED UNSPECIFIED Neuss, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Butter, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kassar, Mohammad UNSPECIFIED orcid.org/0000-0002-7576-2224 UNSPECIFIED Petrescu, Aniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Unterhuber, Matthias UNSPECIFIED orcid.org/0000-0002-8175-276X UNSPECIFIED Thiele, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bardeleben, Ralph Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Schofer, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagl, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Petronio, Anna Sonia UNSPECIFIED UNSPECIFIED UNSPECIFIED Massberg, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Windecker, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lurz, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Metra, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Hausleiter, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-694973
DOI:	10.1016/j.jcmg.2022.05.009
Journal or Publication Title:	JACC-Cardiovasc. Imag.
Volume:	15
Number:	11
Page Range:	S. 1843 - 1852
Date:	2022
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1876-7591
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TO-EDGE REPAIR; HEART-FAILURE; EUROPEAN ASSOCIATION; CONTRACTILE FUNCTION; OUTCOMES; ECHOCARDIOGRAPHY; DYSFUNCTION; THERAPY; SOCIETY Multiple languages Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69497