Key result
Baseline left ventricular end-diastolic volume index > 92 ml/m2 independently increased the risk of cardiovascular death or heart failure rehospitalization (HR 3.63) after percutaneous mitral valve repair.
Why the study?
Percutaneous mitral valve repair has been increasingly performed worldwide, but predictors of clinical outcome in patients undergoing the procedure required investigation.
Observational (n=150)
No
Hazard Ratio: 3.63 (95% CI 1.45–9.09)
p-value: p=0.0062
In patients undergoing percutaneous mitral valve repair, a severely dilated left ventricle (LVEDVi > 92 ml/m2) and advanced heart failure symptoms (NYHA IV) are strong independent predictors of cardiovascular death or heart failure rehospitalization.
Percutaneous mitral valve repair has been increasingly performed worldwide after approval. We sought to investigate predictors of clinical outcome in patients with mitral regurgitation undergoing percutaneous valve repair. The MITRA-UMG study, a single-centre registry, retrospectively collected consecutive patients with symptomatic moderate-to-severe or severe MR undergoing MitraClip therapy. The primary endpoint was the composite of cardiovascular death or rehospitalization for heart failure. Between March 2012 and July 2018, a total of 150 consecutive patients admitted to our institution were included. Procedural success was obtained in 95.3% of patients. The composite primary endpoint of cardiovascular death or rehospitalization for HF was met in 55 patients (37.9%) with cumulative incidences of 7.6%, 26.2%, at 30 days and 1-year, respectively. In the Cox multivariate model, NYHA functional class and left ventricular end-diastolic volume index (LVEDVi), independently increased the risk of the primary endpoint at long-term follow-up. At Kaplan–Meier analysis, a LVEDVi > 92 ml/m2 was associated with an increased incidence of the primary endpoint. In this study, patients presenting with dilated ventricles (LVEDVi > 92 ml/m2) and advanced heart failure symptoms (NYHA IV) at baseline carried the worst prognosis after percutaneous mitral valve repair.
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Polimeni et al. (2020) conducted an observational in Mitral regurgitation (n=150). Left ventricular end-diastolic volume index (LVEDVi) > 92 ml/m2 vs. LVEDVi ≤ 92 ml/m2 was evaluated on Composite of cardiovascular death or rehospitalization for heart failure (HR 3.63, 95% CI 1.45-9.09, p=0.0062). Baseline left ventricular end-diastolic volume index > 92 ml/m2 independently increased the risk of cardiovascular death or heart failure rehospitalization (HR 3.63) after percutaneous mitral valve repair.
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