Prognosis of Elevated Mitral Valve Pressure Gradient After Transcatheter Edge-to-Edge Repair : Systematic Review and Meta-Analysis
Copyright © 2023 Elsevier Inc. All rights reserved..
Elevation in mitral valve pressure gradient (MVPG) after mitral valve transcatheter edge-to-edge repair (M-TEER) is common, however, evidence on its prognosis is scarce and debatable. Thus, this study aims to investigate the impact of increased MVPG after M-TEER on outcomes. Studies reporting the associations between the elevated MVPG after M-TEER and outcomes were identified in a systematic search of published literatures. Associations were pooled by meta-analysis using a random-effects model. The primary outcome was the composite of all-cause mortality and heart failure (HF) hospitalization. Seven observational studies with 2,730 patients (mean age, 77.7 ± 9.3 years; male, 64.4%; functional mitral regurgitation [MR], 65.2%) were eligible for the present analysis. M-TEER was performed entirely using the MitraClip system (Abbott), followed by 29.7% of patients having increased MVPG. Elevated postprocedural MVPG was not associated with a higher risk of the primary outcome, compared to low MVPG [hazard ratio (HR) = 1.22; 95% confidence interval (CI) 0.95-1.58; p = 0.12; I2 = 53.5%). However, the prognosis of elevated MVPG was observed in degenerative MR patients (HR = 1.37; 95% CI 1.03-1.84; p = 0.03; I2 = 0%), whereas not in functional MR patients. Patients with low MVPG + high residual MR had a higher risk of the primary outcome than those with high MVPG + low residual MR after M-TEER (HR = 1.50; 95% CI 1.10-2.03; p = 0.01; I2 = 13%). In conclusion, elevated MVPG seems to predict adverse outcomes mainly in patients with degenerative MR. Future studies are needed to prove these findings.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2024 |
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Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
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Enthalten in: |
Current problems in cardiology - 49(2024), 2 vom: 28. Feb., Seite 102095 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Du, Yu [VerfasserIn] |
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Anmerkungen: |
Date Completed 10.01.2024 Date Revised 28.03.2024 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1016/j.cpcardiol.2023.102095 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM362743096 |
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520 | |a Elevation in mitral valve pressure gradient (MVPG) after mitral valve transcatheter edge-to-edge repair (M-TEER) is common, however, evidence on its prognosis is scarce and debatable. Thus, this study aims to investigate the impact of increased MVPG after M-TEER on outcomes. Studies reporting the associations between the elevated MVPG after M-TEER and outcomes were identified in a systematic search of published literatures. Associations were pooled by meta-analysis using a random-effects model. The primary outcome was the composite of all-cause mortality and heart failure (HF) hospitalization. Seven observational studies with 2,730 patients (mean age, 77.7 ± 9.3 years; male, 64.4%; functional mitral regurgitation [MR], 65.2%) were eligible for the present analysis. M-TEER was performed entirely using the MitraClip system (Abbott), followed by 29.7% of patients having increased MVPG. Elevated postprocedural MVPG was not associated with a higher risk of the primary outcome, compared to low MVPG [hazard ratio (HR) = 1.22; 95% confidence interval (CI) 0.95-1.58; p = 0.12; I2 = 53.5%). However, the prognosis of elevated MVPG was observed in degenerative MR patients (HR = 1.37; 95% CI 1.03-1.84; p = 0.03; I2 = 0%), whereas not in functional MR patients. Patients with low MVPG + high residual MR had a higher risk of the primary outcome than those with high MVPG + low residual MR after M-TEER (HR = 1.50; 95% CI 1.10-2.03; p = 0.01; I2 = 13%). In conclusion, elevated MVPG seems to predict adverse outcomes mainly in patients with degenerative MR. Future studies are needed to prove these findings | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Meta-Analysis | |
650 | 4 | |a Systematic Review | |
700 | 1 | |a Han, Hongya |e verfasserin |4 aut | |
700 | 1 | |a Zhang, Tianhao |e verfasserin |4 aut | |
700 | 1 | |a Shen, Hua |e verfasserin |4 aut | |
700 | 1 | |a Han, Wei |e verfasserin |4 aut | |
700 | 1 | |a Jia, Shuo |e verfasserin |4 aut | |
700 | 1 | |a Yu, Yi |e verfasserin |4 aut | |
700 | 1 | |a Guo, Yonghe |e verfasserin |4 aut | |
700 | 1 | |a Wang, Zhijian |e verfasserin |4 aut | |
700 | 1 | |a Liu, Yuyang |e verfasserin |4 aut | |
700 | 1 | |a Shi, Dongmei |e verfasserin |4 aut | |
700 | 1 | |a Zhou, Yujie |e verfasserin |4 aut | |
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