title: Immediate and 12-Month Outcomes of Ischemic Versus Nonischemic Functional Mitral Regurgitation in Patients Treated With MitraClip (from the 2011 to 2012 Pilot Sentinel Registry of Percutaneous Edge-To-Edge Mitral Valve Repair of the European Society of Cardiology).
abstract: In literature, there are limited data comparing ischemic mitral regurgitation (I-MR) versus nonischemic MR regarding outcomes after percutaneous "edge-to-edge" repair. We aimed to describe the early and 12-month results after MitraClip device implantation regarding the 2 etiologies. From January 2011 to December 2012, the Transcatheter Valve Treatment Sentinel Pilot Registry included 452 patients with MR who underwent MitraClip procedure in 25 centers across Europe. The prevalent etiology was I-MR (235 patients, 52.0%). I-MR group had a significantly higher proportion of men (74.9 vs 59.9%, p <0.001) and surgical risk (logistic EuroSCORE 24.8 ± 18.2 vs 18.8 ± 16.3, p <0.001). Acute procedural success was high (96%) and similar between groups (p = 0.48). Patients with I-MR required a higher, albeit not significant, number of clips to reduce MR (p = 0.08). Inhospital mortality was low (2.0%) without significant differences between etiologies. The estimated 1-year mortality and rehospitalization rates were 15.0% and 25.8%, respectively, without significant differences between groups. Paired echocardiographic data showed a persistent improvement of MR at 1 year in both etiologies. Despite a significant overall reverse atrial remodeling after clip, there were no significant changes in left ventricular volumes. In conclusion, this large independent cohort showed that percutaneous "edge-to-edge" therapy was associated with early- and long-term improvement of MR severity and functional condition both in patients with I-MR and nonischemic MR. There were no significant differences between the 2 etiologies regarding survival and freedom from rehospitalization due to heart failure at the 1-year follow-up.
authors.affiliation: NIHR Biomedical Research Unit Royal Brompton Hospital, London, United Kingdom. Electronic address: michele.pighi@hotmail.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Pighi
authors.affiliation: NIHR Biomedical Research Unit Royal Brompton Hospital, London, United Kingdom.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Estevez-Loureiro
authors.affiliation: Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.affiliation: Department of Cardiology, Policlinico Tor Vergata, University of Rome, Tor Vergata, Italy.
authors.forename: Gian P
authors.initials: GP
authors.lastname: Ussia
authors.affiliation: NIHR Biomedical Research Unit Royal Brompton Hospital, London, United Kingdom.
authors.forename: Gianni
authors.initials: G
authors.lastname: Dall'Ara
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Olaf
authors.initials: O
authors.lastname: Franzen
authors.affiliation: EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Laroche
authors.affiliation: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Settergren
authors.affiliation: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Reidar
authors.initials: R
authors.lastname: Winter
authors.affiliation: Department of Internal Medicine and Cardiology/Pneumology, University of Bonn, Bonn, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.affiliation: Department of Cardiology, Brest University, Brest, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Gilard
authors.affiliation: NIHR Biomedical Research Unit Royal Brompton Hospital, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D009026:Mortality; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome