title: Impact of left ventricular systolic dysfunction on the outcomes of percutaneous edge-to-edge mitral valve repair using MitraClip.
abstract: Left ventricular systolic dysfunction (LVD) is associated with poor outcomes after mitral regurgitation (MR) surgery. MitraClip (MC) is a novel treatment option for MR patients with a high surgical risk. However, outcomes of LVD patients underwent MC remain unclear. In total of 194 patients after MC implantation, 75 patients (39 %) had severe LVD (LV ejection fraction ≤30 %). Patients with severe LVD were primarily male and also younger. Logistic euroSCOREs were comparable between the two groups. Functional MR was more common in patients with severe LVD, while New York Heart Association (NYHA) class was similar between the two groups. N-terminal pro-B-type natriuretic peptide (NT-proBNP) was significantly higher in patients with LVD. In addition to similar improvements in MR severity, NYHA class, and NT-proBNP levels, the survival rates were not different between patients with and without severe LVD. Among patients with severe LVD, the long-term survival rates were significantly lower in patients aged ≥75 years, those with NT-proBNP >5000 pg/mL, and those with atrial fibrillation (AF). In conclusion, severe LVD was not associated with the mortality after MC implantation. MC might be feasible and effective even in the patients with severe MR and low LVEF. However, we need to carefully observe severe LVD patients who are elderly, have a high NT-proBNP level, and have AF, as these might be considered high-risk subjects.
authors.affiliation: Department of Cardiology, Heart Center Brandenburg, Bernau, Germany.|Department of Cardiology, Medical School Brandenburg, Ladeburger Straße 17, 16321, Bernau, Germany.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kaneko
authors.affiliation: Department of Cardiology, Heart Center Brandenburg, Bernau, Germany.|Department of Cardiology, Medical School Brandenburg, Ladeburger Straße 17, 16321, Bernau, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Neuss
authors.affiliation: Department of Cardiology, Heart Center Brandenburg, Bernau, Germany.|Department of Cardiology, Medical School Brandenburg, Ladeburger Straße 17, 16321, Bernau, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schau
authors.affiliation: Department of Cardiology, Heart Center Brandenburg, Bernau, Germany.|Department of Cardiology, Medical School Brandenburg, Ladeburger Straße 17, 16321, Bernau, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Weissenborn
authors.affiliation: Department of Cardiology, Heart Center Brandenburg, Bernau, Germany. c.butter@immanuel.de.|Department of Cardiology, Medical School Brandenburg, Ladeburger Straße 17, 16321, Bernau, Germany. c.butter@immanuel.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Butter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016208:Databases, Factual; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011474:Prosthesis Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Left ventricular dysfunction; Left ventricular ejection fraction; MitraClip; Percutaneous edge-to-edge mitral valve repair