TY - JOUR
T1 - Acute effect of edge-to-edge repair of mitral regurgitation on left heart mechanics and health status
AU - Ro, Richard
AU - Prandi, Francesca R.
AU - Zaid, Syed
AU - Anastasius, Malcolm O.
AU - Tang, Gilbert H.L.
AU - Seetharam, Karthik
AU - Argulian, Edgar
AU - Massaro, Gianluca
AU - Sharma, Samin
AU - Kini, Annapoorna
AU - Lerakis, Stamatios
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - AimsExamine the impact of acute changes in left heart strain and volumes with percutaneous edge-to-edge MitraClip repair on improvement in health status assessed using Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) score.MethodsChanges in left atrial strain, left ventricular (LV) global longitudinal strain (LVGLS), LV end-systolic volume (LVESV), and end-diastolic volume (LVEDV) were evaluated in 50 patients undergoing MitraClip repair for symptomatic primary mitral regurgitation (PMR) and secondary mitral regurgitation (SMR) on transthoracic echocardiography before and 1 month after MitraClip. Multivariable regression was used to evaluate changes in left heart strain and volumes as predictors of change in KCCQ-12 scores, adjusting for baseline clinical and echocardiographic characteristics.ResultsBoth PMR and SMR patients had significant increase in LVGLS and reduction in LVEDV and LVESV (P<0.05) after MitraClip, reduction trend in left atrial conduit strain (PMR P=0.053; SMR P=0.12) but no significant change in LV ejection fraction. KCCQ-12 score improved significantly in both PMR (P<0.001) and SMR cohorts (P<0.001). Higher delta KCCQ-12 tertiles were associated with greater reduction in LVEDV (P=0.022) after MitraClip. On multiple regression analysis, lower preprocedural Society of Thoracic Surgeons for Mitral Valve Replacement and KCCQ-12 score, and greater reduction in LVESV and left atrial strain conduit phase were associated with KCCQ-12 score improvement (P<0.001).ConclusionThere is a significant increase in LVGLS and reduction in LVEDV, LVESV and left atrial strain conduit after edge-to-edge MitraClip repair in both PMR and SMR. Lower preprocedural Society of Thoracic Surgeons for Mitral Valve Replacement and KCCQ-12 score, and greater reduction in LVESV and left atrial conduit strain were associated with KCCQ-12 score improvement after MitraClip. Further studies are warranted to understand the mechanism and significance of our findings.
AB - AimsExamine the impact of acute changes in left heart strain and volumes with percutaneous edge-to-edge MitraClip repair on improvement in health status assessed using Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) score.MethodsChanges in left atrial strain, left ventricular (LV) global longitudinal strain (LVGLS), LV end-systolic volume (LVESV), and end-diastolic volume (LVEDV) were evaluated in 50 patients undergoing MitraClip repair for symptomatic primary mitral regurgitation (PMR) and secondary mitral regurgitation (SMR) on transthoracic echocardiography before and 1 month after MitraClip. Multivariable regression was used to evaluate changes in left heart strain and volumes as predictors of change in KCCQ-12 scores, adjusting for baseline clinical and echocardiographic characteristics.ResultsBoth PMR and SMR patients had significant increase in LVGLS and reduction in LVEDV and LVESV (P<0.05) after MitraClip, reduction trend in left atrial conduit strain (PMR P=0.053; SMR P=0.12) but no significant change in LV ejection fraction. KCCQ-12 score improved significantly in both PMR (P<0.001) and SMR cohorts (P<0.001). Higher delta KCCQ-12 tertiles were associated with greater reduction in LVEDV (P=0.022) after MitraClip. On multiple regression analysis, lower preprocedural Society of Thoracic Surgeons for Mitral Valve Replacement and KCCQ-12 score, and greater reduction in LVESV and left atrial strain conduit phase were associated with KCCQ-12 score improvement (P<0.001).ConclusionThere is a significant increase in LVGLS and reduction in LVEDV, LVESV and left atrial strain conduit after edge-to-edge MitraClip repair in both PMR and SMR. Lower preprocedural Society of Thoracic Surgeons for Mitral Valve Replacement and KCCQ-12 score, and greater reduction in LVESV and left atrial conduit strain were associated with KCCQ-12 score improvement after MitraClip. Further studies are warranted to understand the mechanism and significance of our findings.
KW - MitraClip
KW - mitral regurgitation
KW - strain imaging
KW - transcatheter edge-to-edge repair
UR - http://www.scopus.com/inward/record.url?scp=85141893829&partnerID=8YFLogxK
U2 - 10.2459/JCM.0000000000001359
DO - 10.2459/JCM.0000000000001359
M3 - Article
C2 - 36166336
AN - SCOPUS:85141893829
VL - 23
SP - 787
EP - 797
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 12
ER -