Key result
Transcatheter mitral valve repair using MitraClip significantly improved mitral regurgitation grade (p=0.001), with no difference in efficacy between functional and degenerative etiologies (p=0.89).
Why the study?
With the growing clinical use of transcatheter mitral valve repair, the authors aimed to compare clinical and echocardiographic outcomes between patients with functional versus degenerative mitral regurgitation undergoing edge-to-edge repair.
Does transcatheter mitral valve edge-to-edge repair yield different clinical and echocardiographic outcomes in patients with functional versus degenerative mitral regurgitation?
Cohort (n=111)
Does transcatheter mitral valve edge-to-edge repair yield different clinical and echocardiographic outcomes in patients with functional versus degenerative mitral regurgitation?
p-value: p=0.89
Transcatheter mitral valve edge-to-edge repair provides sustainable symptomatic relief and significant improvement in MR grade that is equally effective in both functional and degenerative mitral regurgitation.
May extend MitraClip to mixed MR etiologies; hypothesis-generating and requires randomized outcome confirmation.
BACKGROUND: The clinical use of transcatheter mitral valve repairis growing. We aimed to compare the clinical and echocardiographic outcomes after transcatheter mitral valve repair using the edge-to-edge technique in patients with functional and degenerative mitral regurgitation (MR). Furthermore, we correlated the clinical and echocardiographic measurements. METHODS: The study included 111 patients who underwent the MitraClip procedure from 2012 to 2018. The patients were divided into two groups according to the etiology; functional mitral regurgitation (FMR) (n = 88; 79.28%) and degenerative mitral regurgitation (DMR) (n = 23; 20.72%). RESULTS: Advanced age (p = 0.002) and FMR (p = 0.001) increased coronary care unit stay, and history of heart failure hospitalization (p = 0.003). Advanced age (p = 0.022) and FMR (p < 0.001) also increased the duration of hospital stay. Severe renal impairment [hazard ratio (HR): 2.6; p < 0.001], female gender (HR: 3.9; p = 0.005), and history of stroke (HR: 5.6; p = 0.065) decreased survival, while post-procedure diuretics improved survival (HR: 0.3; p = 0.024). Moderate residual MR [sub-distribution hazard ratio (SHR): 4.1; p = 0.011], lower EuroSCORE (SHR: 0.9; p = 0.013), and lack of β-blockers (SHR: 0.2; p = 0.034) were predictors of MR recurrence. There were no significant correlations between NYHA class and pulmonary artery pressure (PASP) (p = 0.896), end-systolic (p = 0.856), and end-diastolic diameters (p = 0.965). There were significant improvements in left ventricular dimensions and PASP after MitraClip. However, these changes were not maintained over time. The grade of MR significantly improved after the procedure (p = 0.001), with no difference between groups (p = 0.89). CONCLUSIONS: The MitraClip procedure showed positive results in terms of sustainable symptomatic relief, although this finding was not reflected in left ventricular dimensions. The technique is equally effective in FMR and DMR.
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El‐Shurafa et al. (2021) conducted a cohort in Functional and degenerative mitral regurgitation (n=111). Functional mitral regurgitation (FMR) vs. Degenerative mitral regurgitation (DMR) was evaluated on Improvement in grade of mitral regurgitation (p=0.89). Transcatheter mitral valve repair using MitraClip significantly improved mitral regurgitation grade (p=0.001), with no difference in efficacy between functional and degenerative etiologies (p=0.89).
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