Transcatheter Mitral Repair for Functional Mitral Regurgitation According to Left Ventricular Function: A Real-Life...

Area of Science:

• Cardiology
• Interventional Cardiology
• Heart Failure Management

Background:

• Transcatheter mitral valve repair (TMVR) offers a therapeutic option for functional mitral regurgitation (FMR).
• Left ventricular ejection fraction (LVEF) is a critical factor influencing outcomes after TMVR.
• Understanding LVEF impact is crucial for patient selection and risk stratification in TMVR.

Purpose of the Study:

• To compare the clinical outcomes of TMVR using the MitraClip device in FMR patients stratified by LVEF.
• To evaluate the influence of baseline LVEF (<30% vs. ≥30%) on mortality, hospital readmissions, and functional status post-TMVR.

Main Methods:

• An observational registry study compared outcomes in FMR patients undergoing TMVR.
• Patients were divided into two groups based on LVEF: <30% and ≥30%.
• Propensity-score matching was employed to ensure comparable baseline characteristics, with the primary endpoint being 1-year all-cause mortality and HF readmissions.

Main Results:

• 144 patients with LVEF <30% (group 1) and 144 with LVEF ≥30% (group 2) were matched.
• The primary endpoint occurred significantly more often in group 1 (33.3%) compared to group 2 (9.4%, p=0.002).
• Both groups demonstrated sustained improvements in NYHA functional class and MR severity.

Conclusions:

• FMR patients with LVEF <30% treated with MitraClip experienced higher 1-year mortality and HF readmissions than those with LVEF ≥30%.
• Despite differing mortality rates, both patient groups showed significant improvements in functional capacity and reduction in mitral regurgitation severity.
• LVEF remains an important prognostic indicator in FMR patients undergoing TMVR with MitraClip.