Pulmonary Venous Flow Patterns Associated with Long-term Mitral Transcatheter Edge-to-edge Outcomes.

Echocardiography Outcomes Pulmonary venous flow patterns TEER

Journal

Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese
ISSN: 2241-5955
Titre abrégé: Hellenic J Cardiol
Pays: Netherlands
ID NLM: 101257381

Informations de publication

Date de publication:
29 May 2024
Historique:
received: 26 02 2024
revised: 20 04 2024
accepted: 23 05 2024
medline: 1 6 2024
pubmed: 1 6 2024
entrez: 31 5 2024
Statut: aheadofprint

Résumé

Transcatheter edge-to-edge repair (TEER) is a prominent therapeutic option for mitral regurgitation (MR) patients. However, it lacks objective parameters to assess procedural efficacy. This study aims to investigate the pulmonary venous (PV) flow as a surrogate for valvular hemodynamics and its associations to clinical outcomes. Consecutive MR patients who underwent TEER in our center from 01/2020-10/2021 were retrospectively investigated. PV flow parameters were measured before and after TEER, including velocity (cm/s), velocity time integral (VTI) (cm) and systolic/diastolic ratios. Primary outcomes were 1, 6, and 12 months heart failure hospitalizations (HFH) and 1 year all-cause mortality. The cohort consisted of 80 patients. The mean age was 74.76±10.13 years, 26 with primary and 54 with secondary MR. Systolic wave parameters improved significantly after TEER: mean peak-velocity increased from 9.94±31.95 to 35.74±15.03 cm/s, and VTI from 3.62±5.99 to 8.33±4.72 cm. Furthermore, systolic to diastolic VTI and peak-velocities ratios showed significant improvement 0.39±0.63 to 0.81±0.47 and 0.23±0.66 to 0.91±0.43 respectively. Using multivariable analysis, higher post-procedural S PV flow was significantly improved following TEER, and several hemodynamic parameters were associated HFH and mortality. These results may offer a basis for establishing future procedural goals to ensure better clinical outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Transcatheter edge-to-edge repair (TEER) is a prominent therapeutic option for mitral regurgitation (MR) patients. However, it lacks objective parameters to assess procedural efficacy. This study aims to investigate the pulmonary venous (PV) flow as a surrogate for valvular hemodynamics and its associations to clinical outcomes.
METHODS METHODS
Consecutive MR patients who underwent TEER in our center from 01/2020-10/2021 were retrospectively investigated. PV flow parameters were measured before and after TEER, including velocity (cm/s), velocity time integral (VTI) (cm) and systolic/diastolic ratios. Primary outcomes were 1, 6, and 12 months heart failure hospitalizations (HFH) and 1 year all-cause mortality.
RESULTS RESULTS
The cohort consisted of 80 patients. The mean age was 74.76±10.13 years, 26 with primary and 54 with secondary MR. Systolic wave parameters improved significantly after TEER: mean peak-velocity increased from 9.94±31.95 to 35.74±15.03 cm/s, and VTI from 3.62±5.99 to 8.33±4.72 cm. Furthermore, systolic to diastolic VTI and peak-velocities ratios showed significant improvement 0.39±0.63 to 0.81±0.47 and 0.23±0.66 to 0.91±0.43 respectively. Using multivariable analysis, higher post-procedural S
CONCLUSIONS CONCLUSIONS
PV flow was significantly improved following TEER, and several hemodynamic parameters were associated HFH and mortality. These results may offer a basis for establishing future procedural goals to ensure better clinical outcomes.

Identifiants

pubmed: 38821380
pii: S1109-9666(24)00119-2
doi: 10.1016/j.hjc.2024.05.015
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Competing interests: None.

Auteurs

Tomer Dvir (T)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel; Department of Military Medicine, Hebrew University of Jerusalem, Tzameret Program, Israel.

Itshak Amsalem (I)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel.

Shemy Carasso (S)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel.

Or Gilad (O)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel; Department of Military Medicine, Hebrew University of Jerusalem, Tzameret Program, Israel.

Elad Asher (E)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel.

Danny Dvir (D)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel.

Yael Yan Postell (YY)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel; Department of Military Medicine, Hebrew University of Jerusalem, Tzameret Program, Israel.

Michael Glikson (M)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel.

David Marmor (D)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel.

Mony Shuvy (M)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: monysh@gmail.com.

Classifications MeSH