Cardiovascular medicine heart failure (CVM-HF) index as prognostic model for candidates to MitraClip therapy

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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

4.6K

Gian Paolo Ussia1, Valeria Cammalleri2, Ersilia Mazzotta2

  • 1Department of Cardiovascular Disease, Tor Vergata University of Rome, Viale Oxford, 81, 00133, Rome, Italy. gpussia@hotmail.com.

Heart and Vessels
|December 24, 2015
PubMed

Insights

Transcatheter MitraClip repair outcomes were assessed in severe mitral regurgitation patients using the cardiovascular medicine heart failure (CVM-HF) index. High-risk patients showed poorer survival and higher re-hospitalization rates compared to medium-risk patients.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Heart Failure Management

Background:

  • Severe mitral regurgitation (MR) poses a significant challenge, particularly in patients unsuitable for conventional surgery.
  • Transcatheter MitraClip repair offers a less invasive option for high-risk MR patients.
  • Risk stratification is crucial for optimizing patient selection for MitraClip therapy.

Purpose of the Study:

  • To evaluate one-year clinical outcomes of MitraClip procedures stratified by the cardiovascular medicine heart failure (CVM-HF) index.
  • To compare outcomes between medium-risk (Group B) and high-risk (Group C) patients undergoing MitraClip repair.
  • To assess the utility of the CVM-HF index in predicting MitraClip therapy benefits in advanced heart failure patients with functional MR.

Main Methods:

  • A cohort of 46 consecutive patients undergoing MitraClip repair were divided into three groups based on the CVM-HF index (low, medium, high risk).
  • One-year follow-up data was collected for primary and secondary endpoints.
  • Statistical comparison of outcomes between Group B (medium-risk) and Group C (high-risk) was performed using the log-rank test.

Main Results:

  • High-risk patients (Group C) demonstrated significantly poorer outcomes compared to medium-risk patients (Group B).
  • 12-month survival free from composite events was 44.4% in Group C vs. 74.1% in Group B (p=0.039).
  • 12-month survival free from re-hospitalization was 39.9% in Group C vs. 74.1% in Group B (p=0.036).
  • Cardiac mortality was higher in Group C (16.7%) compared to Group B (0%) (p=0.027).

Conclusions:

  • The CVM-HF index is valuable in identifying patients with advanced heart failure and functional MR who may benefit from MitraClip therapy.
  • High-risk patients, as defined by the CVM-HF index, experience significantly worse one-year outcomes after MitraClip repair.
  • Risk stratification using the CVM-HF index can aid in patient selection for transcatheter mitral valve repair.

Keywords:
Heart failureMitraClipMitral regurgitationPrognosis

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