Impact of heart failure hospitalizations on clinical outcomes after mitral transcatheter edge-to-edge repair: Results from the EXPAND study

被引：2

作者：

Kessler, Mirjam ^{[1
]}

Rottbauer, Wolfgang ^{[1
]}

von Bardeleben, Ralph Stephan ^{[2
]}

Grasso, Carmelo ^{[3
]}

Lurz, Philipp ^{[2
]}

Mahoney, Paul ^{[4
]}

Price, Matthew ^{[5
]}

Williams, Mathew ^{[6
]}

Denti, Paolo ^{[7
]}

Estevez-Loureiro, Rodrigo ^{[8
]}

Kar, Saibal ^{[9
]}

Maisano, Francesco ^{[7
]}

机构：

[1] Univ Ulm, Heart Ctr, Albert Einstein Allee 23, D-89081 Ulm, Germany

[2] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Mainz, Germany

[3] Univ Catania, Ferrarotto Hosp, Catania, Italy

[4] Univ Hosp, Heart Ctr Leipzig, Leipzig, Germany

[5] Scripps Clin, La Jolla, CA USA

[6] New York Univ Langone Hlth, Heart Valve Ctr, New York, NY USA

[7] San Raffaele Univ Hosp, Milan, Italy

[8] Hosp Alvaro Cunqueiro, Vigo, Pontevedra, Spain

[9] HCA Healthcare, Los Robles Reg Med Ctr, Thousand Oaks, CA USA

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2024年 / 26卷 / 07期

关键词：

Heart failure hospitalization; Mitral regurgitation; Mitral valve repair; Transcatheter edge-to-edge repair; VALVE REPAIR; RISK PATIENTS; REGURGITATION; PREDICTORS; READMISSION; ETIOLOGY; THERAPY;

D O I：

10.1002/ejhf.3250

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aim This analysis aimed to compare the clinical outcomes associated with heart failure (HF) readmissions and to identify associations with HF hospitalizations (HFH) in patients treated with the MitraClip (TM) NTR/XTR System in the EXPAND study. Methods and results The global, real-world EXPAND study enrolled 1041 patients with primary or secondary mitral regurgitation (MR) treated with the MitraClip NTR/XTR System. Echocardiograms were analysed by an independent echocardiographic core laboratory. The study population was stratified into HFH and No-HFH groups based on the occurrence of HFH 1 year post-index procedure. Clinical outcomes including MR severity, New York Heart Association (NYHA) functional class, Kansas City Cardiomyopathy Questionnaire (KCCQ) score, and all-cause mortality were compared (HFH: n = 181; No-HFH: n = 860). Both groups achieved consistent 1-year MR reduction to <= 1+ (HFH vs. No-HFH: 87.3% vs. 89.5%, p = 0.6) and significant 1-year improvement in KCCQ scores (+16.5 vs. +22.3, p = 0.09) and NYHA functional class. However, more patients in the No-HFH group had 1-year NYHA class <= II (HFH vs. No-HFH: 67.9% vs. 81.9%, p < 0.01). All-cause mortality at 1 year was 36.8% in the HFH group versus 10.4% in the No-HFH group (p < 0.001). The HFH rate decreased by 63% at 1 year post-M-TEER versus 1 year pre-treatment (relative risk 0.4, p < 0.001). Independent HFH associations were MR >= 2+ at discharge, HFH 1 year prior to treatment, baseline NYHA class >= III, baseline tricuspid regurgitation >= 2+, and baseline left ventricular ejection fraction <= 40%. Conclusions This study reports the impact of HFH on clinical outcomes post-treatment in the EXPAND study. Results demonstrate that the occurrence of HFH was associated with worse 1-year survival, and treatment with the MitraClip system substantially reduced HFH and improved patient symptoms and quality of life.

引用

页码：1495 / 1503

页数：9