Key result
A favorable tricuspid regurgitation course after percutaneous mitral valve repair was associated with lower 1-year mortality (0% vs 13.9%, p=0.057) and greater NYHA improvement (81% vs 45%, p=0.01).
Why the study?
It is unclear to what extent tricuspid regurgitation is reduced after PMVR and whether TR reduction is related to survival and functional outcome.
Does a favorable tricuspid regurgitation course after percutaneous mitral valve repair improve survival and functional outcomes in patients with mitral regurgitation?
Cohort (n=67)
Does a favorable tricuspid regurgitation course after percutaneous mitral valve repair improve survival and functional outcomes in patients with mitral regurgitation?
Answers are grounded in this paper and cite their sources.
A favorable course of tricuspid regurgitation after percutaneous mitral valve repair is achieved in nearly half of patients and is associated with improved functional class and a trend toward better 1-year survival.
Background Tricuspid Regurgitation (TR) is often present in patients with mitral regurgitation (MR) and is associated with increased mortality and morbidity after percutaneous mitral valve repair (PMVR) using the MitraClip (Abbott Vascular). It is unclear to what extent TR is reduced after PMVR and whether the reduction of TR is related to survival and functional outcome. Purpose The aim of this study was to determine (1) the TR course after PMVR and (2) if this was related to survival and clinical outcome. Methods Patients who underwent PMVR and had complete echocardiographic data at baseline and follow-up were included. TR severity was graded as none, mild, moderate or severe (according to current guidelines) and was determined before treatment and at 6-months of follow up. Favorable TR course was defined as improvement of ≥1 grade or ≤ mild TR at 6-months. Clinical endpoints were all-cause mortality during 1-year of follow-up and improvement in New York Heart Association (NYHA) functional class after 6 months. Results A total of 67 patients were included (mean age 76 years, 57% male, 81% NYHA class ≥3 and 69% baseline TR ≥ moderate). Favorable TR course was achieved in 31 patients (46%) (figure 1A). All-cause mortality at 1 year was 7.5%, and was lower in the favorable TR course group (0% vs. 13.9%, p=0.057) (figure 1B). Improvement in NYHA class at 6-months was seen in 45% of patients without vs. 81% of patients with favorable TR course (p=0.01) (figure 1C). Conclusion A favorable TR course is achieved in 46% of PMVR patients and is associated with improved survival and improvement of NYHA class. The relatively high rate of an unfavorable TR course at 6-months, indicates that interventional treatment of the tricuspid valve might benefit these patients. TR course (A) and NYHA improvement (B) Funding Acknowledgement Type of funding source: Other. Main funding source(s): Abbott
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Meijerink et al. (2020) conducted a cohort in Tricuspid Regurgitation in patients undergoing percutaneous mitral valve repair (n=67). Favorable tricuspid regurgitation course vs. Unfavorable tricuspid regurgitation course was evaluated on All-cause mortality at 1 year (p=0.057). A favorable tricuspid regurgitation course after percutaneous mitral valve repair was associated with lower 1-year mortality (0% vs 13.9%, p=0.057) and greater NYHA improvement (81% vs 45%, p=0.01).
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