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Benito-González T, Carrasco-Chinchilla F, Estévez-Loureiro R, Pascual I, Arzamendi D, Garrote-Coloma C, Nombela-Franco L, Pan M, Serrador A, Freixa X, Cid Alvarez AB, Hernández Antolín RA, Andraka L, Cruz-González I, López-Minguez JR, Díez Gil JL, Urbano-Carrillo C, Sanmiguel Cervera D, Sanchís J, Bosa F, Ruíz V, Molina E, Becerra-Muñoz VM, Gualis J, Avanzas P, Li CH, Baz JA, Jimenez-Quevedo P, Mesa D, Amat-Santos IJ, Regueiro A, Trillo R, Domínguez Franco AJ, Alonso-Briales JH, Fernández-Vázquez F. Clinical and echocardiographic outcomes of transcatheter mitral valve repair in atrial functional mitral regurgitation. Int J Cardiol 2021; 345:29-35. [PMID: 34610357 DOI: 10.1016/j.ijcard.2021.09.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/11/2021] [Accepted: 09/27/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Isolated atrial fibrillation can cause mitral regurgitation (MR) in patients with normal left ventricular systolic function and no organic disease of the mitral valve. Little information is available regarding outcomes of Mitraclip in patients with atrial functional mitral regurgitation (AFMR). We aimed to evaluate 12-month clinical and echocardiographic outcomes of transcatheter mitral valve repair (TMVR) with MitraClip in patients with AFMR compared to those with ventricular functional or degenerative/mixed MR. METHODS Registry-based analysis of all consecutive patients who underwent TMVR and were included in the Spanish Registry of Mitraclip. Changes in MR and NYHA functional class, and a combined endpoint including all-cause mortality and hospitalizations due to heart failure were the main outcomes. RESULTS Overall, 1074 (69.1% male, 73.3 ± 10.2 years-old) patients were analyzed in this report. 48 patients (4.5%) presented AFMR. AFMR was significantly reduced after TMVR, with a procedural success rate of 91.7%, and this reduction persisted at 12-month (p < 0.001). Patients with AFMR showed a significant functional improvement at 6- and 12-month follow-up in our series (baseline: NYHA III 70.8% IV 18.8% vs. 1-year: NYHA III 21.7% IV 0%; p < 0.001). The probability of survival free of readmission for heart failure and all-cause mortality within the first year after TMVR was 74.9%. Procedural and clinical outcomes, as well as recurrent rates of MR were similar acutely and at 1-year compared to other etiologies. CONCLUSION TMVR in patients with AFMR showed no significant differences compared to ventricular functional or degenerative/mixed MR regarding MR reduction or clinical outcomes.
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Affiliation(s)
| | - Fernando Carrasco-Chinchilla
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | | | - Isaac Pascual
- Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Dabit Arzamendi
- Division of Interventional Cardiology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | | | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Manuel Pan
- Department of Cardiology, Hospital Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Ana Serrador
- Department of Cardiology, University Clinic Hospital, CIBERCV, Valladolid, Spain
| | - Xavier Freixa
- Department of Cardiology, Cardiovascular Institute, Hospital Clínic, Barcelona, Spain
| | - Ana Belén Cid Alvarez
- Department of Cardiology, University Clinic Hospital, CIBERCV, Santiago de Compostela, Spain
| | | | - Leire Andraka
- Department of Cardiology, Hospital Universitario de Basurto, Bilbao, Spain
| | - Ignacio Cruz-González
- Department of Cardiology, Hospital Universitario de Salamanca, CIBERCV, IBSAL, Salamanca, Spain
| | | | - José Luis Díez Gil
- Department of Cardiology, Hospital Universitario y Politécnico La FE, Valencia, Spain
| | | | - Darío Sanmiguel Cervera
- Unidad de Hemodinámica y Cardiologia Intervencionista, Hospital General de Valencia, Valencia, Spain
| | - Juan Sanchís
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, CIBERCV, Valencia, Spain
| | - Francisco Bosa
- Department of Cardiology, Hospital Universitario de Canarias, Islas Canarias, Spain
| | - Valeriano Ruíz
- Department of Cardiology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Eduardo Molina
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Víctor Manuel Becerra-Muñoz
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | - Javier Gualis
- Department of Cardiology, University Hospital of León, León, Spain
| | - Pablo Avanzas
- Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Chi Hion Li
- Division of Interventional Cardiology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - José Antonio Baz
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
| | | | - Dolores Mesa
- Department of Cardiology, Hospital Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | | | - Ander Regueiro
- Department of Cardiology, Cardiovascular Institute, Hospital Clínic, Barcelona, Spain
| | - Ramiro Trillo
- Department of Cardiology, University Clinic Hospital, CIBERCV, Santiago de Compostela, Spain
| | - Antonio Jesús Domínguez Franco
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | - Juan Horacio Alonso-Briales
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
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