TY - JOUR
T1 - Cardiac Damage in Degenerative Mitral Regurgitation Treated With Transcatheter Mitral Edge-to-Edge Repair
AU - on behalf of the OCEAN-Mitral Investigators
AU - Sugiura, Atsushi
AU - Yamamoto, Masanori
AU - Saji, Mike
AU - Asami, Masahiko
AU - Enta, Yusuke
AU - Nakashima, Masaki
AU - Shirai, Shinichi
AU - Izumo, Masaki
AU - Mizuno, Shingo
AU - Watanabe, Yusuke
AU - Amaki, Makoto
AU - Kodama, Kazuhisa
AU - Yamaguchi, Junichi
AU - Nakajima, Yoshifumi
AU - Naganuma, Toru
AU - Bota, Hiroki
AU - Ohno, Yohei
AU - Yamawaki, Masahiro
AU - Ueno, Hiroshi
AU - Mizutani, Kazuki
AU - Adachi, Yuya
AU - Otsuka, Toshiaki
AU - Kubo, Shunsuke
AU - Nickenig, Georg
AU - Hayashida, Kentaro
N1 - Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024/6/1
Y1 - 2024/6/1
N2 - BACKGROUND: The extent of cardiac damage and its association with clinical outcomes in patients undergoing transcatheter edge-to-edge repair (TEER) for degenerative mitral regurgitation remains unclear. This study was aimed to investigate cardiac damage in patients with degenerative mitral regurgitation treated with TEER and its association with outcomes. METHODS: We analyzed patients with degenerative mitral regurgitation treated with TEER in the Optimized Catheter Valvular Intervention-Mitral registry, which is a prospective, multicenter observational data collection in Japan. The study subjects were classified according to the extent of cardiac damage at baseline: no extravalvular cardiac damage (stage 0), mild left ventricular or left atrial damage (stage 1), moderate left ventricular or left atrial damage (stage 2), or right heart damage (stage 3). Two-year mortality after TEER was compared using Kaplan-Meier analysis. RESULTS: Out of 579 study participants, 8 (1.4%) were classified as stage 0, 76 (13.1%) as stage 1, 319 (55.1%) as stage 2, and 176 (30.4%) as stage 3. Two-year survival was 100% in stage 0, 89.5% in stage 1, 78.9% in stage 2, and 75.3% in stage 3 (P=0.013). Compared with stage 0 to 1, stage 2 (hazard ratio, 3.34 [95% CI, 1.03–10.81]; P=0.044) and stage 3 (hazard ratio, 4.51 [95% CI, 1.37–14.85]; P=0.013) were associated with increased risk of 2-year mortality after TEER. Significant reductions in heart failure rehospitalization rate and New York Heart Association functional scale were observed following TEER (both, P<0.001), irrespective of the stage of cardiac damage. CONCLUSIONS: Advanced cardiac damage is associated with an increased risk of mortality in patients undergoing TEER for degenerative mitral regurgitation. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: UMIN000023653. GRAPHIC ABSTRACT: A graphic abstract is available for this article.
AB - BACKGROUND: The extent of cardiac damage and its association with clinical outcomes in patients undergoing transcatheter edge-to-edge repair (TEER) for degenerative mitral regurgitation remains unclear. This study was aimed to investigate cardiac damage in patients with degenerative mitral regurgitation treated with TEER and its association with outcomes. METHODS: We analyzed patients with degenerative mitral regurgitation treated with TEER in the Optimized Catheter Valvular Intervention-Mitral registry, which is a prospective, multicenter observational data collection in Japan. The study subjects were classified according to the extent of cardiac damage at baseline: no extravalvular cardiac damage (stage 0), mild left ventricular or left atrial damage (stage 1), moderate left ventricular or left atrial damage (stage 2), or right heart damage (stage 3). Two-year mortality after TEER was compared using Kaplan-Meier analysis. RESULTS: Out of 579 study participants, 8 (1.4%) were classified as stage 0, 76 (13.1%) as stage 1, 319 (55.1%) as stage 2, and 176 (30.4%) as stage 3. Two-year survival was 100% in stage 0, 89.5% in stage 1, 78.9% in stage 2, and 75.3% in stage 3 (P=0.013). Compared with stage 0 to 1, stage 2 (hazard ratio, 3.34 [95% CI, 1.03–10.81]; P=0.044) and stage 3 (hazard ratio, 4.51 [95% CI, 1.37–14.85]; P=0.013) were associated with increased risk of 2-year mortality after TEER. Significant reductions in heart failure rehospitalization rate and New York Heart Association functional scale were observed following TEER (both, P<0.001), irrespective of the stage of cardiac damage. CONCLUSIONS: Advanced cardiac damage is associated with an increased risk of mortality in patients undergoing TEER for degenerative mitral regurgitation. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: UMIN000023653. GRAPHIC ABSTRACT: A graphic abstract is available for this article.
KW - cardiac damage
KW - degenerative mitral regurgitation
KW - heart failure
KW - risk stratification
KW - transcatheter edge-to-edge repair
UR - http://www.scopus.com/inward/record.url?scp=85196266692&partnerID=8YFLogxK
U2 - 10.1161/CIRCINTERVENTIONS.123.013794
DO - 10.1161/CIRCINTERVENTIONS.123.013794
M3 - 学術論文
C2 - 38629311
AN - SCOPUS:85196266692
SN - 1941-7640
VL - 17
SP - 498
EP - 508
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
IS - 6
ER -