Percutaneous repair of mitral valve regurgitation in patients with severe heart failure: comparison with optimal medical treatment.
Acta Cardiol
; 73(4): 378-386, 2018 Aug.
Article
en En
| MEDLINE
| ID: mdl-29161956
ABSTRACT
BACKGROUND:
Occurrence of severe mitral valve (MV) regurgitation (MR) is an independent negative predictor of mortality in patients with severe systolic heart failure (HF). This study examines clinical effects and cardiac reverse remodelling in patients with severe systolic HF receiving percutaneous mitral valve repair (PMVR) using MitraClip in comparison to patients receiving optimal medical therapy only.METHODS:
Between 2010 and 2014, 86 patients (Society of Thoracic Surgeons score 10.5% ± 1.2%) with severe HF (left ventricular [LV] ejection fraction; LVEF 25% ± 2%; LV endsystolic diameter [LVESD] 55 ± 3 mm) and severe MR received PMVR using MitraClip. Cardiac reverse remodelling and clinical parameters were compared to HF patients with severe MR (from our HF outpatient clinic; n = 69; LVEF 26% ± 1.4%; LVESD 53 ± 2 mm) receiving optimal medical therapy (OMT) only. All patients received stable OMT and were characterised by echocardiography, 6-minwalk-distance test and cardiac biomarkers within a 24 months observation period.RESULTS:
PMVR in patients with end-stage HF and severe MR resulted in reduction of MR and significant additional cardiac reverse remodelling (LVEF 26 ± 1.4 vs. 33% ± 2%, p < .05; LVESD 53 ± 2 vs. 47 ± 2 mm, p < .05) over the 24 months observation period as compared to pharmacologically-only managed comparators.CONCLUSIONS:
Both OMT and PMVR cause cardiac reverse remodelling and relief of symptoms in patients with HF and severe MR. PMVR results in significant additional cardiac reverse remodelling compared to pharmacologically-only managed patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Inhibidores de la Enzima Convertidora de Angiotensina
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Cateterismo Cardíaco
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Antagonistas Adrenérgicos beta
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Implantación de Prótesis de Válvulas Cardíacas
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Antagonistas de Receptores de Mineralocorticoides
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Insuficiencia Cardíaca
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Insuficiencia de la Válvula Mitral
Tipo de estudio:
Diagnostic_studies
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Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Acta Cardiol
Año:
2018
Tipo del documento:
Article
País de afiliación:
Alemania