Impact of Percutaneous Edge-to-Edge Repair in Patients With Atrial Functional Mitral Regurgitation
Background:The aim of this study was to clarify the clinical outcomes of patients with atrial functional mitral regurgitation (FMR) who underwent the MitraClip procedure compared with those with conventional FMR and sinus rhythm (SR).Methods and Results:Of 303 patients with FMR who underwent the Mit...
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| Veröffentlicht in: | Circulation Journal 2021/06/25, Vol.85(7), pp.1001-1010 |
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| creator | Yoshida, Jun Ikenaga, Hiroki Nagaura, Takafumi Utsunomiya, Hiroto Kawai, Makoto Makar, Moody Rader, Florian Siegel, Robert J. Kar, Saibal Makkar, Raj R. Shiota, Takahiro |
| description | Background:The aim of this study was to clarify the clinical outcomes of patients with atrial functional mitral regurgitation (FMR) who underwent the MitraClip procedure compared with those with conventional FMR and sinus rhythm (SR).Methods and Results:Of 303 patients with FMR who underwent the MitraClip procedure, 40 with “atrial-FMR” defined as FMR with permanent atrial fibrillation and normal left ventricular (LV) function/size and 115 with “sinus-FMR” defined as FMR with SR and LV dysfunction were reviewed. Transthoracic and 3D transesophageal echocardiography, and the cardiac complication rate (composite of all-cause death, heart failure admission, mitral valve (MV) surgery, and redo MitraClip procedure) during the 12-month follow-up were compared between the groups. After the MitraClip procedure, reductions in the mitral annular area and its anteroposterior dimension and in the leaflet closure area were observed in both groups. MV orifice area was smaller with greater transmitral pressure gradient (P |
| doi_str_mv | 10.1253/circj.CJ-20-0971 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_33612563</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2492281577</sourcerecordid><originalsourceid>FETCH-LOGICAL-c424t-5914df2092faf7a9812e808e92adf9cf93d0f7747fa4eb489c3b1211d2d8207a3</originalsourceid><addsrcrecordid>eNqNkEtr3DAUhUVpyXvfVdGyUJTqZUtaBpNpElIaQkqXQpaliQaPPZVkQv995Xia2XajcxHfudxzAPhI8CWhFftqQ7Sby-YOUYywEuQdOCGMC8Qlxe9f5xopydkxOE1pgzFVuFJH4JixuvhrdgLa2-3O2AxHDx9ctFM2gxunBK-7tUN5RLPCR7czIcIwwAeTgxtygr9CfoZXOQbTw9U02BzGoYzfQ45FHt16iuuQzfx9Dj540yd3sdcz8HN1_dTcoPsf326bq3tkOeUZVYrwzlOsqDdeGCUJdRJLp6jpvLJesQ57IbjwhruWS2VZSyghHe1KWmHYGfi87N3F8ffkUtbbkKzr-yWSplxRKkklREHxgto4phSd17sYtib-0QTruVn92qxu7jTFem62WD7tt0_t1nVvhn9VFuDLAry4dvTJlp6se8MwxnVdcUJrPI-Flv9PN_smm3EacrGuFusmZbM-mEzMwfZuf7qstJifQ4QD8GyidgP7C1Yir6k</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2492281577</pqid></control><display><type>article</type><title>Impact of Percutaneous Edge-to-Edge Repair in Patients With Atrial Functional Mitral Regurgitation</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Yoshida, Jun ; Ikenaga, Hiroki ; Nagaura, Takafumi ; Utsunomiya, Hiroto ; Kawai, Makoto ; Makar, Moody ; Rader, Florian ; Siegel, Robert J. ; Kar, Saibal ; Makkar, Raj R. ; Shiota, Takahiro</creator><creatorcontrib>Yoshida, Jun ; Ikenaga, Hiroki ; Nagaura, Takafumi ; Utsunomiya, Hiroto ; Kawai, Makoto ; Makar, Moody ; Rader, Florian ; Siegel, Robert J. ; Kar, Saibal ; Makkar, Raj R. ; Shiota, Takahiro</creatorcontrib><description>Background:The aim of this study was to clarify the clinical outcomes of patients with atrial functional mitral regurgitation (FMR) who underwent the MitraClip procedure compared with those with conventional FMR and sinus rhythm (SR).Methods and Results:Of 303 patients with FMR who underwent the MitraClip procedure, 40 with “atrial-FMR” defined as FMR with permanent atrial fibrillation and normal left ventricular (LV) function/size and 115 with “sinus-FMR” defined as FMR with SR and LV dysfunction were reviewed. Transthoracic and 3D transesophageal echocardiography, and the cardiac complication rate (composite of all-cause death, heart failure admission, mitral valve (MV) surgery, and redo MitraClip procedure) during the 12-month follow-up were compared between the groups. After the MitraClip procedure, reductions in the mitral annular area and its anteroposterior dimension and in the leaflet closure area were observed in both groups. MV orifice area was smaller with greater transmitral pressure gradient (P<0.05) after the procedure in atrial-FMR patients than in those with sinus-FMR. The prevalence of residual MR was similar, but significant tricuspid regurgitation (TR) was more prevalent in the atrial-FMR group at follow-up. Cardiac complication rate was comparable between groups (20% vs. 25%, P=0.63).Conclusions:Reduction of MR occurred in atrial-FMR probably because of the increase in leaflet coaptation area. Significant TR was more common after the MitraClip procedure in patients with atrial-FMR than with sinus-FMR. However, mid-term outcomes were comparable between patients with atrial-FMR and sinus-FMR.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-20-0971</identifier><identifier>PMID: 33612563</identifier><language>eng</language><publisher>TOYKO: The Japanese Circulation Society</publisher><subject>3D transesophageal echocardiography ; Atrial fibrillation ; Cardiac & Cardiovascular Systems ; Cardiovascular System & Cardiology ; Echocardiography, Three-Dimensional ; Echocardiography, Transesophageal ; Functional mitral regurgitation ; Humans ; Life Sciences & Biomedicine ; MitraClip procedure ; Mitral Valve - diagnostic imaging ; Mitral Valve - surgery ; Mitral Valve Insufficiency - diagnostic imaging ; Mitral Valve Insufficiency - surgery ; Science & Technology ; Treatment Outcome ; Ventricular Function, Left</subject><ispartof>Circulation Journal, 2021/06/25, Vol.85(7), pp.1001-1010</ispartof><rights>2021, THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>21</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000665412600006</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c424t-5914df2092faf7a9812e808e92adf9cf93d0f7747fa4eb489c3b1211d2d8207a3</citedby><cites>FETCH-LOGICAL-c424t-5914df2092faf7a9812e808e92adf9cf93d0f7747fa4eb489c3b1211d2d8207a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1884,27929,27930,39263</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33612563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoshida, Jun</creatorcontrib><creatorcontrib>Ikenaga, Hiroki</creatorcontrib><creatorcontrib>Nagaura, Takafumi</creatorcontrib><creatorcontrib>Utsunomiya, Hiroto</creatorcontrib><creatorcontrib>Kawai, Makoto</creatorcontrib><creatorcontrib>Makar, Moody</creatorcontrib><creatorcontrib>Rader, Florian</creatorcontrib><creatorcontrib>Siegel, Robert J.</creatorcontrib><creatorcontrib>Kar, Saibal</creatorcontrib><creatorcontrib>Makkar, Raj R.</creatorcontrib><creatorcontrib>Shiota, Takahiro</creatorcontrib><title>Impact of Percutaneous Edge-to-Edge Repair in Patients With Atrial Functional Mitral Regurgitation</title><title>Circulation Journal</title><addtitle>CIRC J</addtitle><addtitle>Circ J</addtitle><description>Background:The aim of this study was to clarify the clinical outcomes of patients with atrial functional mitral regurgitation (FMR) who underwent the MitraClip procedure compared with those with conventional FMR and sinus rhythm (SR).Methods and Results:Of 303 patients with FMR who underwent the MitraClip procedure, 40 with “atrial-FMR” defined as FMR with permanent atrial fibrillation and normal left ventricular (LV) function/size and 115 with “sinus-FMR” defined as FMR with SR and LV dysfunction were reviewed. Transthoracic and 3D transesophageal echocardiography, and the cardiac complication rate (composite of all-cause death, heart failure admission, mitral valve (MV) surgery, and redo MitraClip procedure) during the 12-month follow-up were compared between the groups. After the MitraClip procedure, reductions in the mitral annular area and its anteroposterior dimension and in the leaflet closure area were observed in both groups. MV orifice area was smaller with greater transmitral pressure gradient (P<0.05) after the procedure in atrial-FMR patients than in those with sinus-FMR. The prevalence of residual MR was similar, but significant tricuspid regurgitation (TR) was more prevalent in the atrial-FMR group at follow-up. Cardiac complication rate was comparable between groups (20% vs. 25%, P=0.63).Conclusions:Reduction of MR occurred in atrial-FMR probably because of the increase in leaflet coaptation area. Significant TR was more common after the MitraClip procedure in patients with atrial-FMR than with sinus-FMR. However, mid-term outcomes were comparable between patients with atrial-FMR and sinus-FMR.</description><subject>3D transesophageal echocardiography</subject><subject>Atrial fibrillation</subject><subject>Cardiac & Cardiovascular Systems</subject><subject>Cardiovascular System & Cardiology</subject><subject>Echocardiography, Three-Dimensional</subject><subject>Echocardiography, Transesophageal</subject><subject>Functional mitral regurgitation</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>MitraClip procedure</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - surgery</subject><subject>Mitral Valve Insufficiency - diagnostic imaging</subject><subject>Mitral Valve Insufficiency - surgery</subject><subject>Science & Technology</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkEtr3DAUhUVpyXvfVdGyUJTqZUtaBpNpElIaQkqXQpaliQaPPZVkQv995Xia2XajcxHfudxzAPhI8CWhFftqQ7Sby-YOUYywEuQdOCGMC8Qlxe9f5xopydkxOE1pgzFVuFJH4JixuvhrdgLa2-3O2AxHDx9ctFM2gxunBK-7tUN5RLPCR7czIcIwwAeTgxtygr9CfoZXOQbTw9U02BzGoYzfQ45FHt16iuuQzfx9Dj540yd3sdcz8HN1_dTcoPsf326bq3tkOeUZVYrwzlOsqDdeGCUJdRJLp6jpvLJesQ57IbjwhruWS2VZSyghHe1KWmHYGfi87N3F8ffkUtbbkKzr-yWSplxRKkklREHxgto4phSd17sYtib-0QTruVn92qxu7jTFem62WD7tt0_t1nVvhn9VFuDLAry4dvTJlp6se8MwxnVdcUJrPI-Flv9PN_smm3EacrGuFusmZbM-mEzMwfZuf7qstJifQ4QD8GyidgP7C1Yir6k</recordid><startdate>20210625</startdate><enddate>20210625</enddate><creator>Yoshida, Jun</creator><creator>Ikenaga, Hiroki</creator><creator>Nagaura, Takafumi</creator><creator>Utsunomiya, Hiroto</creator><creator>Kawai, Makoto</creator><creator>Makar, Moody</creator><creator>Rader, Florian</creator><creator>Siegel, Robert J.</creator><creator>Kar, Saibal</creator><creator>Makkar, Raj R.</creator><creator>Shiota, Takahiro</creator><general>The Japanese Circulation Society</general><general>Japanese Circulation Soc</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210625</creationdate><title>Impact of Percutaneous Edge-to-Edge Repair in Patients With Atrial Functional Mitral Regurgitation</title><author>Yoshida, Jun ; Ikenaga, Hiroki ; Nagaura, Takafumi ; Utsunomiya, Hiroto ; Kawai, Makoto ; Makar, Moody ; Rader, Florian ; Siegel, Robert J. ; Kar, Saibal ; Makkar, Raj R. ; Shiota, Takahiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-5914df2092faf7a9812e808e92adf9cf93d0f7747fa4eb489c3b1211d2d8207a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>3D transesophageal echocardiography</topic><topic>Atrial fibrillation</topic><topic>Cardiac & Cardiovascular Systems</topic><topic>Cardiovascular System & Cardiology</topic><topic>Echocardiography, Three-Dimensional</topic><topic>Echocardiography, Transesophageal</topic><topic>Functional mitral regurgitation</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>MitraClip procedure</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - surgery</topic><topic>Mitral Valve Insufficiency - diagnostic imaging</topic><topic>Mitral Valve Insufficiency - surgery</topic><topic>Science & Technology</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshida, Jun</creatorcontrib><creatorcontrib>Ikenaga, Hiroki</creatorcontrib><creatorcontrib>Nagaura, Takafumi</creatorcontrib><creatorcontrib>Utsunomiya, Hiroto</creatorcontrib><creatorcontrib>Kawai, Makoto</creatorcontrib><creatorcontrib>Makar, Moody</creatorcontrib><creatorcontrib>Rader, Florian</creatorcontrib><creatorcontrib>Siegel, Robert J.</creatorcontrib><creatorcontrib>Kar, Saibal</creatorcontrib><creatorcontrib>Makkar, Raj R.</creatorcontrib><creatorcontrib>Shiota, Takahiro</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshida, Jun</au><au>Ikenaga, Hiroki</au><au>Nagaura, Takafumi</au><au>Utsunomiya, Hiroto</au><au>Kawai, Makoto</au><au>Makar, Moody</au><au>Rader, Florian</au><au>Siegel, Robert J.</au><au>Kar, Saibal</au><au>Makkar, Raj R.</au><au>Shiota, Takahiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Percutaneous Edge-to-Edge Repair in Patients With Atrial Functional Mitral Regurgitation</atitle><jtitle>Circulation Journal</jtitle><stitle>CIRC J</stitle><addtitle>Circ J</addtitle><date>2021-06-25</date><risdate>2021</risdate><volume>85</volume><issue>7</issue><spage>1001</spage><epage>1010</epage><pages>1001-1010</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:The aim of this study was to clarify the clinical outcomes of patients with atrial functional mitral regurgitation (FMR) who underwent the MitraClip procedure compared with those with conventional FMR and sinus rhythm (SR).Methods and Results:Of 303 patients with FMR who underwent the MitraClip procedure, 40 with “atrial-FMR” defined as FMR with permanent atrial fibrillation and normal left ventricular (LV) function/size and 115 with “sinus-FMR” defined as FMR with SR and LV dysfunction were reviewed. Transthoracic and 3D transesophageal echocardiography, and the cardiac complication rate (composite of all-cause death, heart failure admission, mitral valve (MV) surgery, and redo MitraClip procedure) during the 12-month follow-up were compared between the groups. After the MitraClip procedure, reductions in the mitral annular area and its anteroposterior dimension and in the leaflet closure area were observed in both groups. MV orifice area was smaller with greater transmitral pressure gradient (P<0.05) after the procedure in atrial-FMR patients than in those with sinus-FMR. The prevalence of residual MR was similar, but significant tricuspid regurgitation (TR) was more prevalent in the atrial-FMR group at follow-up. Cardiac complication rate was comparable between groups (20% vs. 25%, P=0.63).Conclusions:Reduction of MR occurred in atrial-FMR probably because of the increase in leaflet coaptation area. Significant TR was more common after the MitraClip procedure in patients with atrial-FMR than with sinus-FMR. However, mid-term outcomes were comparable between patients with atrial-FMR and sinus-FMR.</abstract><cop>TOYKO</cop><pub>The Japanese Circulation Society</pub><pmid>33612563</pmid><doi>10.1253/circj.CJ-20-0971</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 3D transesophageal echocardiography Atrial fibrillation Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Echocardiography, Three-Dimensional Echocardiography, Transesophageal Functional mitral regurgitation Humans Life Sciences & Biomedicine MitraClip procedure Mitral Valve - diagnostic imaging Mitral Valve - surgery Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - surgery Science & Technology Treatment Outcome Ventricular Function, Left |
| title | Impact of Percutaneous Edge-to-Edge Repair in Patients With Atrial Functional Mitral Regurgitation |
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