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Association of heart failure duration with clinical outcomes after transcatheter mitral valve repair for functional mitral regurgitation
Author(s) -
Sugiura Atsushi,
Weber Marcel,
Tabata Noriaki,
Goto Tadahiro,
Grube Eberhard,
Treede Hendrik,
Werner Nikos,
Nickenig Georg,
Sinning JanMalte
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29390
Subject(s) - medicine , mitraclip , hazard ratio , heart failure , cardiology , mitral regurgitation , proportional hazards model , functional mitral regurgitation , mitral valve , surgery , confidence interval , ejection fraction
Background Little is known about the association of heart failure (HF) chronicity with clinical outcomes after transcatheter mitral valve repair (TMVR) for functional mitral regurgitation (MR). Methods From January 2011 to March 2019, consecutive patients with functional MR who underwent a MitraClip procedure were analyzed. The patients were divided into two groups according to HF duration—those with duration ≤18 months and those with >18 months. The primary outcome measure was a composite of all‐cause mortality and re‐HF rehospitalization within 1 year after the procedure. These outcomes were also assessed separately. A Cox proportional hazard model was conducted for investigating the association of HF duration with the primary outcome. Results A total of 208 patients were analyzed. Patients with HF duration >18 months had a higher rate of the primary outcome compared to those with HF duration ≤18 months (38.1 vs. 19.0%, log‐rank p = .003). A longer duration of HF was associated with an increased risk of the primary outcomes (adjusted‐HR of >18 months, 2.12 95% CI, 1.14–4.19; p = .03; adjusted‐HR (hazard ratios) for 1 year increase, 1.05; 95% CI, 1.02–1.09; p = .004). The association of HF duration with the primary outcomes showed a steep rise during the first 2 years of HF duration and progressive increase after 5 years. Conclusions A longer HF duration before TMVR was associated with an increased risk of all‐cause mortality or HF rehospitalization. HF duration can be used for the risk stratification marker in patients undergoing TMVR for functional MR.