Key result
MitraClip review identifies the ideal patient phenotype and optimal timing for secondary MR in HFrEF.
Why the study?
To review the pathophysiology of SMR in HFrEF progression, reconcile findings from randomized trials and real-world registries, and identify optimal patient phenotypes and timing for MitraClip treatment.
This review synthesizes evidence from trials and registries to identify the ideal patient phenotype and optimal timing for MitraClip treatment in secondary mitral regurgitation with HFrEF.
May refine MitraClip selection in HFrEF with secondary MR; leaves open prospective validation of phenotypes and timing.
Transcatheter mitral valve intervention using the MitraClip system has evolved as a new tool for the treatment of secondary mitral regurgitation (SMR) in patients with heart failure and reduced left ventricular ejection fraction (HFrEF). The purposes of this paper are, first, to review the pathophysiological mechanisms underlying the onset of SMR within the context of HFrEF progression; secondly, to reconcile the results from MitraClip randomized clinical trials and “real-world” registries, in order to highlight in a patient-based strategy the most relevant clinical predictors of favorable outcome after MitraClip implantation. The final goal is to identify the phenotype of the “ideal” patient and the most favorable timing for MitraClip treatment of SMR within the broad spectrum of HFrEF presentation.
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Godino et al. (2020) conducted a review in Secondary mitral regurgitation in heart failure with reduced ejection fraction (HFrEF). MitraClip was evaluated. This review synthesizes evidence from trials and registries to identify the ideal patient phenotype and optimal timing for MitraClip treatment of secondary mitral regurgitation in HFrEF.
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