1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Department of Cardiac Surgery, Medical University of Warsaw, Warsaw, Poland
Kardiol Pol. 2021 Feb 25;79(2):179-184. doi: 10.33963/KP.15680. Epub 2020 Nov 6.
Data on the impact of transcatheter aortic valve implantation (TAVI) on coexisting mitral regurgitation (MR) are still inconsistent.
The study aimed to evaluate the impact of TAVI on coexistent MR depending on its etiology.
Out of 311 patients treated with TAVI, we selected 48 with coexistent MR: functional (FMR; n = 26) or nonfunctional (nFMR; n = 22). The impact of the procedure on MR was quantitatively assessed during a 1‑year follow‑up using MR effective regurgitant orifice area (MR‑EROA) and volume (MRV).
Compared with baseline, no change of MR‑EROA was observed at 1‑year follow‑up in all patients with MR (median [interquartile range (IQR)], 0.2 [0.17-0.23]cm2 vs 0.17 [0.14-0.2]cm2 ; P = 0.054). No change in MR‑EROA was also noted either in FMR (median [IQR], 0.21 [0.17-0.27]cm2 vs 0.19 [0.14-0.25]cm2 ; P = 0.142) or nFMR (median [IQR], 0.17 [0.12-0.23] cm2 vs 0.17 [0.1-0.2] cm2 ; P = 0.238) cohorts. Decreased MRV was seen in theoverall MR population after TAVI (median [IQR], 32 [28-36]ml/beat vs 26 [22-28]ml/beat; P = 0.002). Similarly, decreased MRV was noted in both FMR (median [IQR], 33 [26-42] ml/beat vs 26 [20-40] ml/beat; P = 0.042) and nFMR (median [IQR], 30 [20-46] ml/beat vs 24 [15-33] ml/beat; P = 0.015) cohorts.
Transcatheter aortic valve implantation had no impact on MR‑EROA regardless of the etiology of regurgitation. However, the procedure reduced MRV in both FMR and nFMR.
经导管主动脉瓣置换术（TAVI）对并存二尖瓣反流（MR）的影响仍存在不一致。
本研究旨在根据病因评估 TAVI 对并存 MR 的影响。
在接受 TAVI 治疗的 311 例患者中，我们选择了 48 例并存 MR 的患者：功能性（FMR；n = 26）或非功能性（nFMR；n = 22）。在 1 年的随访期间，使用 MR 有效反流口面积（MR-EROA）和容积（MRV）对手术对 MR 的影响进行定量评估。
与基线相比，所有 MR 患者在 1 年随访时的 MR-EROA 无变化（中位数[四分位数范围（IQR）]，0.2[0.17-0.23]cm2 vs 0.17[0.14-0.2]cm2；P = 0.054）。FMR（中位数[IQR]，0.21[0.17-0.27]cm2 vs 0.19[0.14-0.25]cm2；P = 0.142）或 nFMR（中位数[IQR]，0.17[0.12-0.23]cm2 vs 0.17[0.1-0.2]cm2；P = 0.238）患者的 MR-EROA 也无变化。TAVI 后整体 MR 人群的 MRV 降低（中位数[IQR]，32[28-36]ml/beat vs 26[22-28]ml/beat；P = 0.002）。同样，FMR（中位数[IQR]，33[26-42]ml/beat vs 26[20-40]ml/beat；P = 0.042）和 nFMR（中位数[IQR]，30[20-46]ml/beat vs 24[15-33]ml/beat；P = 0.015）患者的 MRV 也降低。
无论反流的病因如何，TAVI 对 MR-EROA 均无影响。然而，该手术可降低 FMR 和 nFMR 患者的 MRV。
