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Asgar AW, Tang GHL, Rogers JH, Rottbauer W, Morse MA, Denti P, Mahoney P, Rinaldi MJ, Asch FM, Zamorano JL, Dong M, Huang R, Lindenfeld J, Maisano F, von Bardeleben RS, Kar S, Rodriguez E. Evaluating Mitral TEER in the Management of Moderate Secondary Mitral Regurgitation Among Heart Failure Patients. JACC. HEART FAILURE 2024:S2213-1779(24)00600-0. [PMID: 39269396 DOI: 10.1016/j.jchf.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 07/24/2024] [Accepted: 08/06/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Moderate secondary mitral regurgitation (SMR) represents a subgroup of heart failure (HF) patients with treatment restricted to medical therapy. Outcomes in patients with moderate SMR treated with mitral transcatheter edge-to-edge repair (M-TEER) are less well known. OBJECTIVES The aim of this study was to assess the safety and effectiveness of M-TEER in subjects with moderate SMR using the EXPANDed studies. METHODS One-year outcomes in subjects from the EXPANDed studies (EXPAND [A Contemporary, Prospective Study Evaluating Real-world Experience of Performance and Safety for the Next Generation of MitraClip Devices] and EXPAND G4 [A Post-Market Study Assessment of the Safety and Performance of the MitraClip G4 System] MitraClip studies) with baseline moderate SMR (2+), per echocardiographic core laboratory (ECL) assessment, were compared with subjects with baseline severe SMR (≥3+). RESULTS There were 335 subjects with moderate SMR and 525 with severe SMR at baseline per ECL review. Baseline characteristics were similar between the 2 subgroups. After treatment with M-TEER, significant MR reduction was achieved in both groups. Significant left ventricular (LV) reverse remodeling was observed through 1 year, with a >20 mL decrease in LV end-diastolic and end-systolic volumes on average in the moderate SMR group. Significant 1-year improvements in NYHA functional class (>78% NYHA functional class I or II) and quality of life (>20 points on the Kansas City Cardiomyopathy Questionnaire-Overall Summary) were observed in subjects with moderate SMR. Similarly, low rates of major adverse events, all-cause mortality, and HF hospitalizations were observed between the 2 subgroups through 1 year. CONCLUSIONS In the EXPANDed studies, subjects with moderate SMR treated with M-TEER had improvements similar to subjects with severe SMR in quality of life and positive LV remodeling at 1 year. Future studies are needed to evaluate if M-TEER would be beneficial for HF patients with moderate SMR.
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Affiliation(s)
| | - Gilbert H L Tang
- Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA
| | - Jason H Rogers
- University of California-Davis, Sacramento, California, USA
| | | | | | - Paolo Denti
- San Raffaele University Hospital, Milan, Italy
| | - Paul Mahoney
- University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA
| | - Michael J Rinaldi
- Sanger Heart and Vascular Institute of Cardiothoracic Surgery, Charlotte, North Carolina, USA
| | - Federico M Asch
- Cardiovascular Core Laboratories, MedStar Health Research Institute, Washington, DC, USA
| | - Jose L Zamorano
- Department of Cardiology, Ramón y Cajal University Hospital, Madrid, Spain
| | - Melody Dong
- Abbott Structural Heart, Santa Clara, California, USA
| | - Rong Huang
- Abbott Structural Heart, Santa Clara, California, USA
| | | | - Francesco Maisano
- Division of Cardiac Surgery and Valve Center, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Saibal Kar
- Los Robles Regional, Thousand Oaks, California, USA
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Shah UA, Rashid A, Mufti SA, Khan S, Qazi ZM, Masoom I, Khuja ZA, Bukhari I, Kakroo SA, Rather H. Clinical profile, treatment patterns and one-year outcome of heart failure patients admitted in tertiary care hospital of North India. J Family Med Prim Care 2024; 13:3225-3230. [PMID: 39228559 PMCID: PMC11368373 DOI: 10.4103/jfmpc.jfmpc_1868_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/24/2024] [Accepted: 04/01/2024] [Indexed: 09/05/2024] Open
Abstract
Introduction Because of wide heterogeneity in the epidemiology of heart failure among different populations, it is imperative to establish population-specific databases. Aims and Objectives To describe the clinical profile, treatment patterns, and outcomes of heart failure patients admitted to our tertiary care hospital. Material and Methods The study was a prospective observational study conducted over two years at our tertiary care hospital. It included patients admitted with acute and acute-on-chronic heart failure. Results We recruited 264 patients. Mean age of the study population was 57.8 ± 15.14 years. Males were 157 (59.5%). Dilated cardiomyopathy was the most common cause followed by ischemic heart disease. Most common risk factors were hypertension, tobacco use, anemia, and diabetes. Heart failure with reduced ejection fraction was present in 154 (62%) patients. Acute de novo heart failure was present in 91 (34.5%) patients. The most common precipitant for heart failure exacerbation was infection, followed by ischemic causes and non-adherence to drugs. The mean duration of hospital stay was 7.5 ± 3.1 days. The in-hospital mortality was 8.7%, and cumulative six-month and one-year mortality was 23% and 28%, respectively. In multivariate analysis, renal failure, readmission, and not being on guideline-directed medical treatment were significant predictors of mortality. Conclusion Our patients were younger, predominantly males, with dilated and ischemic cardiomyopathy as commonest etiology. Hypertension and tobacco smoking were most common risk factors, with infections as most common precipitants. Only one-third of patients were on guideline-directed medical therapy. The one-year mortality was 28% and was higher in those without guideline-directed medical therapy.
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Affiliation(s)
- Usaid A. Shah
- Department of Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Aamir Rashid
- Department of Cardiology, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Showkat A. Mufti
- Department of Emergency Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Saba Khan
- Department of Paediatrics, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Zahid M. Qazi
- Department of Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Injeela Masoom
- Department of Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Zubair A. Khuja
- Department of Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Immia Bukhari
- Department of Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Shahood A. Kakroo
- Department of Cardiology, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Hilal Rather
- Department of Cardiology, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
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Pabon MA, Vaduganathan M, Lam CSP. Is the optimal dose of heart failure medical therapy different in women and men? Eur J Heart Fail 2024; 26:1699-1702. [PMID: 38800983 DOI: 10.1002/ejhf.3320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 05/19/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Maria A Pabon
- Cardiovascular Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Muthiah Vaduganathan
- Cardiovascular Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carolyn S P Lam
- National Heart Centre Singapore, Duke-National University of Singapore, Singapore, Singapore
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Carnethon MR, Hill JA, Al-Khatib SM. Eighth Annual Go Red for Women Issue. Circulation 2024; 149:487-488. [PMID: 38346105 DOI: 10.1161/circulationaha.124.068737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Affiliation(s)
- Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (M.R.C.)
| | - Joseph A Hill
- Division of Cardiology, University of Texas Southwestern (J.A.H.)
- Harry S. Moss Heart Center, Dallas, TX (J.A.H.)
| | - Sana M Al-Khatib
- Division of Cardiology, Duke University Medical Center, Durham, NC (S.M.A.-K.)
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