Key result
Transcatheter mitral valve repair with MitraClip in FMR patients with LVEF <30% had higher one-year mortality and HF readmissions than those with LVEF ≥30% (33.3% vs. 9.4%, p=0.002).
Why the study?
TMVR could improve survival in FMR, but the influence of LVEF on outcomes needed to be considered.
Does an LVEF <30% compared to LVEF ≥30% worsen the combined outcome of one-year all-cause mortality and unplanned heart failure readmissions in patients with functional mitral regurgitation undergoing transcatheter mitral valve repair?
Observational (n=288)
Does an LVEF <30% compared to LVEF ≥30% worsen the combined outcome of one-year all-cause mortality and unplanned heart failure readmissions in patients with functional mitral regurgitation undergoing transcatheter mitral valve repair?
Absolute Event Rate: 33.3% vs 9.4%
p-value: p=0.002
In patients with functional mitral regurgitation undergoing transcatheter mitral valve repair, an LVEF <30% is associated with significantly higher one-year mortality and heart failure readmissions compared to an LVEF ≥30%, though both groups experience symptomatic improvement.
Background: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip® between two groups according to LVEF. Methods: In an observational registry study, we compared the outcomes in patients with FMR who underwent TMVR with and without LVEF <30%. The primary endpoint was the combined one-year all-cause mortality and unplanned hospital readmissions due to HF. The secondary end-points were New York Heart Association (NYHA) functional class and mitral regurgitation (MR) severity. Propensity-score matching was used to create two groups with the same baseline characteristics, except for baseline LVEF. Results: Among 535 FMR eligible patients, 144 patients with LVEF <30% (group 1) and 144 with LVEF >30% (group 2) had similar propensity scores and were included in the analyses. The primary study endpoint was significantlly higher in group 1 (33.3% vs. 9.4%, p = 0.002). There was a maintained improvement in secondary endpoints without significant differences among groups. Conclusion: FMR patients with LVEF <30% treated with MitraClip® had higher mortality and readmissions than patients with LVEF ≥30% treated with the same device. However, both groups improved the NYHA functional class and MR severity.
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Pascual et al. (2020) conducted an observational in Functional mitral regurgitation (n=288). Transcatheter mitral valve repair with MitraClip (LVEF <30%) vs. Transcatheter mitral valve repair with MitraClip (LVEF >30%) was evaluated on Combined one-year all-cause mortality and unplanned hospital readmissions due to HF (p=0.002). Transcatheter mitral valve repair with MitraClip in FMR patients with LVEF <30% had higher one-year mortality and HF readmissions than those with LVEF ≥30% (33.3% vs. 9.4%, p=0.002).
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