title: MitraClip® therapy in patients with end-stage systolic heart failure.
abstract: OBJECTIVE
  To assess the feasibility, short-term durability and clinical outcomes of MitraClip® therapy for mitral regurgitation (MR) in patients with end-stage heart failure and a severely reduced left ventricular (LV) ejection fraction.
  
  
  RESULTS
  We analysed retrospectively collected data from seven European centres. Included in the study were 50 heart failure patients [mean age 70 ± 11 years, 38 men (76%)] with a LV ejection fraction ≤25% and MR of at least grade 3+. All patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, and their mean logistic EuroSCORE was 34%. The patients underwent a total of 53 MitraClip® procedures; one or more clips were implanted in 50 procedures (48 patients), for an acute procedural success rate of 94%. Severity of MR was reduced in all successfully treated patients, 44 (92%) were discharged with MR ≤2+. Thirty-day mortality was 6%; cumulative survival at 6 months was 81.2%. Clinical and echocardiographic 6-month follow-up data were obtained from 32 and 31 successfully treated patients, respectively. At 6 months, MR ≤2+ was present in 27 (87%) of 31 patients, and 23 (72%) of 32 patients were in NYHA functional class I or II. Six-minute walk distance improved significantly, and significant reductions in LV volumes indicative of reverse LV remodelling were concordant with significant reductions in N-terminal pro-brain natriuretic peptide plasma levels.
  
  
  CONCLUSIONS
  MitraClip® therapy reduces functional MR in patients with end-stage heart failure and marked LV dysfunction and entails clinical benefit at 6 months.
authors.affiliation: Department of General and Interventional Cardiology, University Heart Centre, Hamburg, Germany. owfranzen@gmx.de
authors.forename: Olaf
authors.initials: O
authors.lastname: Franzen
authors.forename: Jan
authors.initials: J
authors.lastname: van der Heyden
authors.forename: Stephan
authors.initials: S
authors.lastname: Baldus
authors.forename: Michael
authors.initials: M
authors.lastname: Schlüter
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schillinger
authors.forename: Christian
authors.initials: C
authors.lastname: Butter
authors.forename: Rainer
authors.initials: R
authors.lastname: Hoffmann
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pedrazzini
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Swaans
authors.forename: Michael
authors.initials: M
authors.lastname: Neuss
authors.forename: Volker
authors.initials: V
authors.lastname: Rudolph
authors.forename: Daniel
authors.initials: D
authors.lastname: Sürder
authors.forename: Jürg
authors.initials: J
authors.lastname: Grünenfelder
authors.forename: Christine
authors.initials: C
authors.lastname: Eulenburg
authors.forename: Hermann
authors.initials: H
authors.lastname: Reichenspurner
authors.forename: Thomas
authors.initials: T
authors.lastname: Meinertz
authors.forename: Angelo
authors.initials: A
authors.lastname: Auricchio
mesh_terms: D000368:Aged; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D019736:Prostheses and Implants; D013318:Stroke Volume; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain