Schlendorf Kelly H, O'Leary Jared, Lindenfeld JoAnn
Vanderbilt University Medical Center Nashville, TN.
US Cardiol. 2020 Jul 14;14:e06. doi: 10.15420/usc.2020.05. eCollection 2020.
Secondary mitral regurgitation (MR) is common in patients with left heart dysfunction and it is associated with poor outcomes. Findings from the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trial, published in 2018, suggest that in a subset of people with heart failure with secondary MR that persists despite optimization of guideline-directed medical therapies, there is now a role for percutaneous mitral valve repair using the MitraClip device. Defining which patients are most likely to benefit from MitraClip, and when, requires both a multidisciplinary approach centered on heart failure, as well as a recognition of the need for further research in this area.
继发性二尖瓣反流（MR）在左心功能不全患者中很常见，且与不良预后相关。2018年发表的心力衰竭功能性二尖瓣反流患者经皮MitraClip治疗心血管结局评估（COAPT）试验结果表明，在一部分尽管优化了指南指导的药物治疗但仍存在继发性MR的心力衰竭患者中，现在使用MitraClip装置进行经皮二尖瓣修复有了用武之地。确定哪些患者最有可能从MitraClip中获益以及何时获益，既需要以心力衰竭为中心的多学科方法，也需要认识到该领域进一步研究的必要性。
