Changes in serum biomarker profiles after percutaneous mitral valve repair with the MitraClip system.
BACKGROUND
Mitral regurgitation (MR) is one of the most common valvular diseases. Percu-taneous mitral valve repair with the MitraClipTM system is a novel percutaneous mitral valve repair (PMVR) technique for high-surgical-risk patients. However, the effect of PMVR on cir-culating cardiac or inflammatory biomarkers and their association with individual functional, echocardiographic and clinical outcomes is poorly investigated.


METHODS
A group of 144 patients with functional or degenerative MR (age, 75 ± 11 years; 41% females) underwent PMVR with the MitraClip system at the University Heart Center Zu-rich. Serum biomarkers as N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP) and creatinine were obtained from venous sampling at baseline and follow-up of 3-6 months.


RESULTS
Median NT-proBNP decreased insignificantly from 2,942 (IQR 1,596-5,722) to 2,739 (IQR 1,440-4,296) ng/L, p = 0.21. NT-proBNP changes did not correlate with baseline left ventricular (LV) ejection fraction or LV dimensions, with New York Heart Association class on follow-up, or with clinical events on follow-up. CRP levels reached a peak on the third postoperative day at 34.0 mg/L with a subsequent slow decrease over the ensuing days.


CONCLUSIONS
Despite successful PMVR, NT-proBNP remain fairly unchanged on follow-up and changes in NT-proBNP levels are poor predictors of functional improvement or clinical outcome after MitraClip treatment.
Ji-Na
JN
Yoon
Antonio H
AH
Frangieh
Adrian
A
Attinger-Toller
Christiane
C
Gruner
Felix C
FC
Tanner
Maurizio
M
Taramasso
Roberto
R
Corti
Thomas F
TF
Lüscher
Frank
F
Ruschitzka
Dominique
D
Bettex
Francesco
F
Maisano
University Heart Center, University Hospital Zurich. oliver.gaemperli@usz.ch.
Oliver
O
Gaemperli
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011184:Postoperative Period; D011379:Prognosis; D011474:Prosthesis Design; D012189:Retrospective Studies; D012720:Severity of Illness Index
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
MitraClip; NT-proBNP; mitral regurgitation; percutaneous mitral valve repair; serum biomarkers