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Myocardial Infarction and Functional Outcome Assessment in Pigs
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Myocardial fibrosis predicts adverse outcome after MitraClip implantation

Juliëtte F Velu1, Alexander Hirsch2, S M Boekholdt1

  • 1Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Center, University of Amsterdam, Amsterdam, The Netherlands.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 4, 2018
PubMed
Abstract

Insights

Myocardial fibrosis, detected via cardiovascular magnetic resonance, predicts adverse outcomes in high-risk mitral regurgitation patients receiving the MitraClip device. This finding may aid clinical decision-making for these complex cases.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • High-risk patients with mitral regurgitation (MR) often undergo percutaneous mitral valve repair using the MitraClip.
  • Identifying which patients will benefit from MitraClip implantation remains challenging.

Purpose of the Study:

  • To investigate if myocardial fibrosis predicts outcomes in MR patients treated with MitraClip.
  • To assess the utility of myocardial fibrosis detection in clinical decision-making for MitraClip procedures.

Main Methods:

  • Preprocedural cardiovascular magnetic resonance (CMR) with late gadolinium enhancement was used to analyze myocardial fibrosis.
  • Adverse outcome was defined as New York Heart Association (NYHA) class III-IV or death within one month post-MitraClip implantation.

Main Results:

  • Myocardial fibrosis was identified in a significant proportion of patients (55% degenerative MR, 64% functional MR).
  • Patients with myocardial fibrosis had a substantially higher rate of adverse outcomes (69%) compared to those without (11%, P=0.01).

Conclusions:

  • The presence of myocardial fibrosis is a predictor of adverse outcomes in patients undergoing MitraClip implantation for MR.
  • Further studies with larger sample sizes are needed to confirm these findings and integrate myocardial fibrosis assessment into clinical decision-making and prognosis evaluation.
Keywords:
MitraClipmyocardial fibrosispercutaneous mitral valve repair

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