Acute effect of edge-to-edge repair of mitral regurgitation on left heart mechanics and health status.
J Cardiovasc Med (Hagerstown)
; 23(12): 787-797, 2022 12 01.
Article
em En
| MEDLINE
| ID: mdl-36166336
ABSTRACT
AIMS:
Examine the impact of acute changes in left heart strain and volumes with percutaneous edge-to-edge MitraClip repair on improvement in health status assessed using Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) score.METHODS:
Changes in left atrial strain, left ventricular (LV) global longitudinal strain (LVGLS), LV end-systolic volume (LVESV), and end-diastolic volume (LVEDV) were evaluated in 50 patients undergoing MitraClip repair for symptomatic primary mitral regurgitation (PMR) and secondary mitral regurgitation (SMR) on transthoracic echocardiography before and 1 month after MitraClip. Multivariable regression was used to evaluate changes in left heart strain and volumes as predictors of change in KCCQ-12 scores, adjusting for baseline clinical and echocardiographic characteristics.RESULTS:
Both PMR and SMR patients had significant increase in LVGLS and reduction in LVEDV and LVESV ( P â<â0.05) after MitraClip, reduction trend in left atrial conduit strain (PMR P â=â0.053; SMR P â=â0.12) but no significant change in LV ejection fraction. KCCQ-12 score improved significantly in both PMR ( P â<â0.001) and SMR cohorts ( P â<â0.001). Higher delta KCCQ-12 tertiles were associated with greater reduction in LVEDV ( P â=â0.022) after MitraClip. On multiple regression analysis, lower preprocedural Society of Thoracic Surgeons for Mitral Valve Replacement and KCCQ-12 score, and greater reduction in LVESV and left atrial strain conduit phase were associated with KCCQ-12 score improvement ( P â<â0.001).CONCLUSION:
There is a significant increase in LVGLS and reduction in LVEDV, LVESV and left atrial strain conduit after edge-to-edge MitraClip repair in both PMR and SMR. Lower preprocedural Society of Thoracic Surgeons for Mitral Valve Replacement and KCCQ-12 score, and greater reduction in LVESV and left atrial conduit strain were associated with KCCQ-12 score improvement after MitraClip. Further studies are warranted to understand the mechanism and significance of our findings.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Implante de Prótese de Valva Cardíaca
/
Insuficiência da Valva Mitral
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article