Yoon Ji-Na, Frangieh Antonio H, Attinger-Toller Adrian, Gruner Christiane, Tanner Felix C, Taramasso Maurizio, Corti Roberto, Lüscher Thomas F, Ruschitzka Frank, Bettex Dominique, Maisano Francesco, Gaemperli Oliver
University Heart Center, University Hospital Zurich.
Cardiol J. 2016;23(4):384-92. doi: 10.5603/CJ.a2016.0024. Epub 2016 Jun 14.
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.
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.
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.
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.
二尖瓣反流（MR）是最常见的瓣膜疾病之一。使用MitraClipTM系统进行经皮二尖瓣修复是一种针对高手术风险患者的新型经皮二尖瓣修复（PMVR）技术。然而，PMVR对循环心脏或炎症生物标志物的影响及其与个体功能、超声心动图和临床结局的关联研究较少。
一组144例功能性或退行性MR患者（年龄75±11岁；41%为女性）在苏黎世大学心脏中心接受了使用MitraClip系统的PMVR。在基线和3 - 6个月随访时通过静脉采血获取血清生物标志物，如N末端B型利钠肽原（NT-proBNP）、C反应蛋白（CRP）和肌酐。
NT-proBNP中位数从2942（四分位间距1596 - 5722）降至2739（四分位间距1440 - 4296）ng/L，无显著下降，p = 0.21。NT-proBNP变化与基线左心室（LV）射血分数或LV尺寸、随访时的纽约心脏协会分级或随访时的临床事件均无相关性。CRP水平在术后第三天达到峰值34.0 mg/L，随后在接下来的几天内缓慢下降。
尽管PMVR成功，但随访时NT-proBNP基本保持不变，NT-proBNP水平变化对MitraClip治疗后功能改善或临床结局的预测价值较差。
