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Prognostic impact of right ventricular dysfunction following transcatheter mitral valve repair
  • +11
  • Shingo Kuwata,
  • Masaki Izumo,
  • noriko Shiokawa,
  • Sato Yukio,
  • Ryo Kamijima,
  • Shunichi Doi,
  • Haruka Nishikawa,
  • Toshiki Kaihara,
  • Masashi Koga,
  • Kazuaki Okuyama,
  • Yasuhiro Tanabe,
  • Tomoo Harada,
  • Yuki Ishibashi,
  • Yoshihiro Akashi
Shingo Kuwata
St. Marianna University School of Medicine
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Masaki Izumo
St. Marianna University School of Medicine
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noriko Shiokawa
St. Marianna University School of Medicine
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Sato Yukio
St. Marianna University School of Medicine
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Ryo Kamijima
St. Marianna University School of Medicine
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Shunichi Doi
St. Marianna University School of Medicine
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Haruka Nishikawa
St. Marianna University School of Medicine
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Toshiki Kaihara
St. Marianna University School of Medicine
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Masashi Koga
St. Marianna University School of Medicine
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Kazuaki Okuyama
St. Marianna University School of Medicine
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Yasuhiro Tanabe
St. Marianna University School of Medicine
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Tomoo Harada
St. Marianna University School of Medicine
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Yuki Ishibashi
St. Marianna University School of Medicine
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Yoshihiro Akashi
St. Marianna University School of Medicine
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Abstract

Background Little is known regarding the impact of right ventricular (RV) function on clinical outcomes following MitraClip therapy. Objectives The aim of this study was to investigate the prognostic impact of RV dysfunction and its cut-off value following MitraClip therapy. Methods Consecutive 77 patients (median 79 years, 33% female) who underwent MitraClip therapy were enrolled. Clinical endpoint was defined as cardiovascular (CV) events, including cardiovascular death and rehospitalization for heart failure (HF). Results and conclusions Twenty-two (29%) patients had primary mitral regurgitation (MR). During follow-up, 5 patients died due to CV events, 8 were hospitalized for HF. On univariate Cox regression analysis, CV events were associated with eGFR (HR; 0.960, 95% CI; 0.926–0.995, p = 0.027), tricuspid annular plane systolic excursion (TAPSE, HR; 0.874, 95% CI; 0.789–0.968, p = 0.010), and significant residual MR (HR; 11.652, 95% CI; 3.257–41.691, p <0.001). On multivariate Cox regression analysis, TAPSE (HR; 0.788, 95% CI; 0.788–0.987, p = 0.029) and significant residual MR (HR; 9.373, 95% CI; 2.581–34.033, p = 0.001) were independently associated with CV events. TAPSE <11 mm was the best cut-off criteria for predicting CV events. RV function was independently associated with clinical outcomes following MitraClip therapy. TAPSE is a simple parameter for predicting CV events in patients with MR who are undergoing MitraClip therapy.