Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality
OBJECTIVES The purpose of this study was to examine the impact of residual mitral regurgitation (MR) on mortality in patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND MR is common in patients undergoing TAVR. Data on optimal management of patients with significant MR afte...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2021 |
| País: | España |
| Institución: | Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| Repositorio: | r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| OAI Identifier: | oai:iibsantpau.fundanetsuite.com:p4604 |
| Acceso en línea: | https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4604 https://pure.eur.nl/en/publications/effect-of-transcatheter-aortic-valve-replacement-on-concomitant-m |
| Access Level: | acceso abierto |
| Palabra clave: | aortic stenosis mitral regurgitation TAVR TMVR/r |
| id |
ES_9c333fcbf0b8d7be26907d9ffd42eaee |
|---|---|
| oai_identifier_str |
oai:iibsantpau.fundanetsuite.com:p4604 |
| network_acronym_str |
ES |
| network_name_str |
España |
| repository_id_str |
|
| spelling |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on MortalityWitberg, GCodner, PLandes, USchwartzenberg, SBarbanti, MValvo, RDe Backer, OOoms, JFIslas, FMarroquin, LSedaghat, ASugiura, AMasiero, GWerner, PArmario, XFiorina, CArzamendi, DSantos-Martinez, SFernandez-Vazquez, FBaz, JASteblovnik, KMauri, VAdam, MMerdler, IHein, MRuile, PGrasso, CBranca, LEstevez-Loureiro, RBenito-Gonzalez, TAmat-Santos, IJMylotte, DAndreas, MBunc, MTarantini, GSinning, JMNombela-Franco, LSondergaard, LVan Mieghem, NMFinkelstein, AKornowski, Raortic stenosismitral regurgitationTAVRTMVR/rOBJECTIVES The purpose of this study was to examine the impact of residual mitral regurgitation (MR) on mortality in patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND MR is common in patients undergoing TAVR. Data on optimal management of patients with significant MR after TAVR are limited. METHODS The registry consisted of 16 TAVR centers (n = 7,303). Outcomes of patients with $ moderate versus lesser grade MR after TAVR were compared. RESULTS In 1,983 (27.2%) patients, baseline MR grade was $ moderate. MR regressed in 874 (44.1%) patients and persisted in 1,109 (55.9%) after TAVR. Four-year mortality was higher for those with MR persistence, but not for those with MR regression after TAVR, compared with nonsignificant baseline MR (43.8% vs. 35.1% vs. 32.4%; hazard ratio [HR]: 1.38; p = 0.008; HR: 1.02; p = 0.383, respectively). New York Heart Association functional class III to IV after TAVR was more common in those with MR persistence vs. regression (14.4% vs. 3.9%; p < 0.001). In a propensity score-matched cohort (91 patients' pairs), with significant residual MR after TAVR who did or did not undergo staged mitral intervention, staged intervention was associated with a better functional class through 1 year of follow-up (82.4% vs. 33.3% New York Heart Association functional class I or II; p < 0.001), and a numerically lower 4-year mortality, which was not statistically significant (64.6% vs. 37.5%; HR: 1.66; p = 0.097). CONCLUSIONS Risk stratification based on improvement in MR and symptoms after TAVR can identify patients at increased mortality risk after TAVR. These patients may benefit from a staged transcatheter mitral intervention, but this requires further proof from future studies. (C) 2021 by the American College of Cardiology Foundation.ELSEVIER SCIENCE INC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4604https://pure.eur.nl/en/publications/effect-of-transcatheter-aortic-valve-replacement-on-concomitant-mJACC-Cardiovascular InterventionsISSN: 19368798ISSNe: 18767605reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p46042026-06-14T12:41:47Z |
| dc.title.none.fl_str_mv |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality |
| title |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality |
| spellingShingle |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality Witberg, G aortic stenosis mitral regurgitation TAVR TMVR/r |
| title_short |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality |
| title_full |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality |
| title_fullStr |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality |
| title_full_unstemmed |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality |
| title_sort |
Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality |
| dc.creator.none.fl_str_mv |
Witberg, G Codner, P Landes, U Schwartzenberg, S Barbanti, M Valvo, R De Backer, O Ooms, JF Islas, F Marroquin, L Sedaghat, A Sugiura, A Masiero, G Werner, P Armario, X Fiorina, C Arzamendi, D Santos-Martinez, S Fernandez-Vazquez, F Baz, JA Steblovnik, K Mauri, V Adam, M Merdler, I Hein, M Ruile, P Grasso, C Branca, L Estevez-Loureiro, R Benito-Gonzalez, T Amat-Santos, IJ Mylotte, D Andreas, M Bunc, M Tarantini, G Sinning, JM Nombela-Franco, L Sondergaard, L Van Mieghem, NM Finkelstein, A Kornowski, R |
| author |
Witberg, G |
| author_facet |
Witberg, G Codner, P Landes, U Schwartzenberg, S Barbanti, M Valvo, R De Backer, O Ooms, JF Islas, F Marroquin, L Sedaghat, A Sugiura, A Masiero, G Werner, P Armario, X Fiorina, C Arzamendi, D Santos-Martinez, S Fernandez-Vazquez, F Baz, JA Steblovnik, K Mauri, V Adam, M Merdler, I Hein, M Ruile, P Grasso, C Branca, L Estevez-Loureiro, R Benito-Gonzalez, T Amat-Santos, IJ Mylotte, D Andreas, M Bunc, M Tarantini, G Sinning, JM Nombela-Franco, L Sondergaard, L Van Mieghem, NM Finkelstein, A Kornowski, R |
| author_role |
author |
| author2 |
Codner, P Landes, U Schwartzenberg, S Barbanti, M Valvo, R De Backer, O Ooms, JF Islas, F Marroquin, L Sedaghat, A Sugiura, A Masiero, G Werner, P Armario, X Fiorina, C Arzamendi, D Santos-Martinez, S Fernandez-Vazquez, F Baz, JA Steblovnik, K Mauri, V Adam, M Merdler, I Hein, M Ruile, P Grasso, C Branca, L Estevez-Loureiro, R Benito-Gonzalez, T Amat-Santos, IJ Mylotte, D Andreas, M Bunc, M Tarantini, G Sinning, JM Nombela-Franco, L Sondergaard, L Van Mieghem, NM Finkelstein, A Kornowski, R |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
aortic stenosis mitral regurgitation TAVR TMVR/r |
| topic |
aortic stenosis mitral regurgitation TAVR TMVR/r |
| description |
OBJECTIVES The purpose of this study was to examine the impact of residual mitral regurgitation (MR) on mortality in patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND MR is common in patients undergoing TAVR. Data on optimal management of patients with significant MR after TAVR are limited. METHODS The registry consisted of 16 TAVR centers (n = 7,303). Outcomes of patients with $ moderate versus lesser grade MR after TAVR were compared. RESULTS In 1,983 (27.2%) patients, baseline MR grade was $ moderate. MR regressed in 874 (44.1%) patients and persisted in 1,109 (55.9%) after TAVR. Four-year mortality was higher for those with MR persistence, but not for those with MR regression after TAVR, compared with nonsignificant baseline MR (43.8% vs. 35.1% vs. 32.4%; hazard ratio [HR]: 1.38; p = 0.008; HR: 1.02; p = 0.383, respectively). New York Heart Association functional class III to IV after TAVR was more common in those with MR persistence vs. regression (14.4% vs. 3.9%; p < 0.001). In a propensity score-matched cohort (91 patients' pairs), with significant residual MR after TAVR who did or did not undergo staged mitral intervention, staged intervention was associated with a better functional class through 1 year of follow-up (82.4% vs. 33.3% New York Heart Association functional class I or II; p < 0.001), and a numerically lower 4-year mortality, which was not statistically significant (64.6% vs. 37.5%; HR: 1.66; p = 0.097). CONCLUSIONS Risk stratification based on improvement in MR and symptoms after TAVR can identify patients at increased mortality risk after TAVR. These patients may benefit from a staged transcatheter mitral intervention, but this requires further proof from future studies. (C) 2021 by the American College of Cardiology Foundation. |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4604 https://pure.eur.nl/en/publications/effect-of-transcatheter-aortic-valve-replacement-on-concomitant-m |
| url |
https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4604 https://pure.eur.nl/en/publications/effect-of-transcatheter-aortic-valve-replacement-on-concomitant-m |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
| eu_rights_str_mv |
openAccess |
| dc.publisher.none.fl_str_mv |
ELSEVIER SCIENCE INC |
| publisher.none.fl_str_mv |
ELSEVIER SCIENCE INC |
| dc.source.none.fl_str_mv |
JACC-Cardiovascular Interventions ISSN: 19368798 ISSNe: 18767605 reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| instname_str |
Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| reponame_str |
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| collection |
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| repository.name.fl_str_mv |
|
| repository.mail.fl_str_mv |
|
| _version_ |
1869414637249757184 |
| score |
15,81155 |