Kheifets Mark, Angelini Filippo, D'Ascenzo Fabrizio, Pidello Stefano, Engelstein Haya, Bocchino Pier Paolo, Boretto Paolo, Frea Simone, Levi Amos, Vaknin-Assa Hana, Vaturi Mordehay, Shapira Yaron, Kornowski Ran, Perl Leor
Division of Cardiology, Rabin Medical Center, 39 Ze'ev Jabotinsky St., Petach Tikva 4941492, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
J Clin Med. 2022 Oct 12;11(20):6010. doi: 10.3390/jcm11206010.
Current guidelines support the use of transcatheter edge-to-edge repair (TEER) for patients with both primary and secondary mitral regurgitation. We aimed to compare the prognoses of TEER in degenerative mitral regurgitation (DMR) vs. functional mitral regurgitation (FMR). A total of 208 consecutive patients who underwent TEER over a ten-year period were analyzed. Primary endpoints included rates of all-cause death and major adverse cardiac events (MACE: composite of all-cause death, hospitalizations for heart failure, mitral valve surgery, or TEER re-intervention). A total of 148 (71%) patients were identified with FMR, while 60 (29%) were identified with DMR. Patients in the FMR group were younger (77.2 ± 8.4 vs. 80.2 ± 7.2, = 0.02), suffered more frequently from coronary artery disease (54.1% vs. 10.0%, = 0.02), and atrial fibrillation/flutter (70.9% vs. 38.3%, = 0.02). Rates of 1-year death (21.6% vs. 10.0%, = 0.03) and MACE (41.2% vs. 21.7%, = 0.02) were higher for the FMR group, as compared to the DMR group. After correcting for variables, FMR independently predicted rates of MACE (HR-1.78, 95% CI 1.23-2.48, = 0.04) and had a non-significant effect on one-year mortality (HR-1.67, 95%CI 0.98-3.74, = 0.07). In our experience, worse overall 1-year composite MACE outcomes were observed after TEER in patients with FMR as compared to patients with DMR.
当前指南支持对原发性原发性原发性原发性和继发性二尖瓣反流患者使用经导管缘对缘修复术（TEER）。我们旨在比较退行性二尖瓣反流（DMR）与功能性二尖瓣反流（FMR）患者接受TEER后的预后情况。对在十年期间连续接受TEER的208例患者进行了分析。主要终点包括全因死亡率和主要不良心脏事件（MACE：全因死亡、因心力衰竭住院、二尖瓣手术或TEER再次干预的综合指标）。共识别出148例（71%）FMR患者，60例（29%）DMR患者。FMR组患者更年轻（77.2±8.4岁 vs. 80.2±7.2岁，P = 0.02），冠心病（54.1% vs. 10.0%，P = 0.02）和心房颤动/扑动（70.9% vs. 38.3%，P = 0.02）的发生率更高。与DMR组相比，FMR组1年死亡率（21.6% vs. 10.0%，P = 0.03）和MACE发生率（（41.2% vs. 21.7%，P = 0.02）更高。校正变量后，FMR独立预测MACE发生率（HR = 1.78，95%CI 1.23 - 2.48，P = 0.04），对1年死亡率有非显著性影响（HR = 1.67，95%CI 0.98 - 3.74，P = 0.07）。根据我们的经验，与DMR患者相比，FMR患者接受TEER后1年综合MACE总体结局更差。
