Outcomes of MitraClip for Secondary Mitral Regurgitation Reported
No difference seen across mitral valve gradient quartiles for two-year composite end point of all-cause mortality, heart failure hospitalization
WEDNESDAY, April 28, 2021 (HealthDay News) -- For patients with heart failure and secondary mitral regurgitation (SMR), higher mitral valve gradient (MVG) after MitraClip treatment does not appear to compromise clinical outcomes, according to a study published in the April 26 issue of JACC: Cardiovascular Interventions.
Rim Halaby, M.D., from the University of Pennsylvania in Philadelphia, and colleagues divided patients who underwent MitraClip treatment for SMR into quartiles based on discharge echocardiographic MVG and examined the association between mean MVG and clinical outcomes.
The researchers found that after MitraClip, the mean MVG was 2.1 ± 0.4 mm Hg, 3.0 ± 0.2 mm Hg, 4.2 ± 0.5 mm Hg, and 7.2 ± 2.0 mm Hg in quartiles 1, 2, 3, and 4, respectively. The two-year composite end point of all-cause mortality or heart failure hospitalization did not differ across quartiles (43.2, 49.2, 40.6, and 40.9 percent, respectively). There were also no differences across quartiles in improvement in New York Heart Association functional class, Kansas City Cardiomyopathy Questionnaire score, or six-minute walk time. After adjustment for baseline clinical and echocardiographic characteristics, postprocedure MR grade, and number of clips, the results were similar.
"[These] data [are] very reassuring for physicians who place MitraClips in patients with secondary mitral regurgitation," a coauthor said in a statement. "It demonstrates that the benefits of MR reduction in patients with heart failure were maintained even when mild-to-moderate mitral stenosis, which can be caused by a narrowing of the mitral valve, occurred after MitraClip."
Several authors disclosed financial ties to biopharmaceutical companies, including Abbott, which manufactures the MitraClip and funded the study.