Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study

J. F. Ooms; M. L. Geleijnse; E. Spitzer; B. Ren; M. P. Van Wiechen; T. W. Hokken; J. Daemen; P. P.T. de Jaegere; N. M.D.A. Van Mieghem

doi:10.1007/s12471-021-01583-6

Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study

J. F. Ooms, M. L. Geleijnse, E. Spitzer, B. Ren, M. P. Van Wiechen, T. W. Hokken, J. Daemen, P. P.T. de Jaegere, N. M.D.A. Van Mieghem^*

^*Corresponding author for this work

Cardiology

Research output: Contribution to journal › Review article › Academic › peer-review

1 Citation (Scopus)

Abstract

Background: Functional mitral regurgitation (FMR) can be subclassified based on its proportionality relative to left ventricular function and end-diastolic volume. FMR proportionality could help identify responders to transcatheter edge-to-edge mitral valve repair (MitraClip) in terms of residual FMR and/or clinical improvement. Methods: This single-centre retrospective cohort study evaluated the feasibility of determining FMR proportionality in symptomatic heart failure patients with reduced left ventricular function who were treated with MitraClip for ≥ moderate-to-severe FMR. Baseline proportionate (pFMR) and disproportionate FMR (dFMR) were distinguished. Patient characteristics and MitraClip procedural outcomes were described. Results: From an overall cohort of 81 eligible FMR patients, 23/81 (28%) had to be excluded due to missing transthoracic echocardiogram parameters, 22/81 were excluded based on FMR severity. The remaining cohort, of 36/81 patients (44%), could be classified into dFMR (n = 26) or pFMR (n = 10). Conduction disorders were numerically increased in dFMR. All cases requiring > 2 clips were in the dFMR group and absence of FMR reduction occurred more frequently with dFMR. Point of view/Conclusion: Important limitations in terms of imaging acquisition affect the translation of the FMR proportionality concept to a real-world data set. We did observe different demographic and FMR response patterns in patients with proportionate and disproportionate FMR that warrant further investigation.

Original language	English
Pages (from-to)	359-364
Number of pages	6
Journal	Netherlands Heart Journal
Volume	29
Issue number	7-8
DOIs	https://doi.org/10.1007/s12471-021-01583-6
Publication status	Published - 8 Jun 2021

Bibliographical note

Funding Information:
N.M.D.A. Van Mieghem has received a research grant support from Boston Scientific, Edwards Lifesciences, Abbot Vascular and PulseCath B.V. which were received for activities outside the submitted work. J. Daemen received institutional grant/research support from AstraZeneca, Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, ReCor medical and PulseCath, and consultancy and speaker fees from ACIST medical, Boston Scientific, ReCor Medical, Pie Medical, Medtronic and Pulse Cath. J.F. Ooms, M.L. Geleijnse, E. Spitzer, B. Ren, M.P. Van Wiechen, T.W. Hokken and P.P.T. de Jaegere declare that they have no competing interests.

Publisher Copyright:
© 2021, The Author(s).

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Ooms, J. F., Geleijnse, M. L., Spitzer, E., Ren, B., Van Wiechen, M. P., Hokken, T. W., Daemen, J., de Jaegere, P. P. T., & Van Mieghem, N. M. D. A. (2021). Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study. Netherlands Heart Journal, 29(7-8), 359-364. https://doi.org/10.1007/s12471-021-01583-6

@article{fc69c8a6675446cb9cdf01e3996dcff8,

title = "Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study",

abstract = "Background: Functional mitral regurgitation (FMR) can be subclassified based on its proportionality relative to left ventricular function and end-diastolic volume. FMR proportionality could help identify responders to transcatheter edge-to-edge mitral valve repair (MitraClip) in terms of residual FMR and/or clinical improvement. Methods: This single-centre retrospective cohort study evaluated the feasibility of determining FMR proportionality in symptomatic heart failure patients with reduced left ventricular function who were treated with MitraClip for ≥ moderate-to-severe FMR. Baseline proportionate (pFMR) and disproportionate FMR (dFMR) were distinguished. Patient characteristics and MitraClip procedural outcomes were described. Results: From an overall cohort of 81 eligible FMR patients, 23/81 (28%) had to be excluded due to missing transthoracic echocardiogram parameters, 22/81 were excluded based on FMR severity. The remaining cohort, of 36/81 patients (44%), could be classified into dFMR (n = 26) or pFMR (n = 10). Conduction disorders were numerically increased in dFMR. All cases requiring > 2 clips were in the dFMR group and absence of FMR reduction occurred more frequently with dFMR. Point of view/Conclusion: Important limitations in terms of imaging acquisition affect the translation of the FMR proportionality concept to a real-world data set. We did observe different demographic and FMR response patterns in patients with proportionate and disproportionate FMR that warrant further investigation.",

author = "Ooms, {J. F.} and Geleijnse, {M. L.} and E. Spitzer and B. Ren and {Van Wiechen}, {M. P.} and Hokken, {T. W.} and J. Daemen and {de Jaegere}, {P. P.T.} and {Van Mieghem}, {N. M.D.A.}",

note = "Funding Information: N.M.D.A. Van Mieghem has received a research grant support from Boston Scientific, Edwards Lifesciences, Abbot Vascular and PulseCath B.V. which were received for activities outside the submitted work. J. Daemen received institutional grant/research support from AstraZeneca, Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, ReCor medical and PulseCath, and consultancy and speaker fees from ACIST medical, Boston Scientific, ReCor Medical, Pie Medical, Medtronic and Pulse Cath. J.F. Ooms, M.L. Geleijnse, E. Spitzer, B. Ren, M.P. Van Wiechen, T.W. Hokken and P.P.T. de Jaegere declare that they have no competing interests. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = jun,

day = "8",

doi = "10.1007/s12471-021-01583-6",

language = "English",

volume = "29",

pages = "359--364",

journal = "Netherlands Heart Journal",

issn = "1568-5888",

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number = "7-8",

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Ooms, JF , Geleijnse, ML, Spitzer, E, Ren, B , Van Wiechen, MP , Hokken, TW , Daemen, J , de Jaegere, PPT & Van Mieghem, NMDA 2021, 'Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study', Netherlands Heart Journal, vol. 29, no. 7-8, pp. 359-364. https://doi.org/10.1007/s12471-021-01583-6

TY - JOUR

T1 - Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study

AU - Ooms, J. F.

AU - Geleijnse, M. L.

AU - Spitzer, E.

AU - Ren, B.

AU - Van Wiechen, M. P.

AU - Hokken, T. W.

AU - Daemen, J.

AU - de Jaegere, P. P.T.

AU - Van Mieghem, N. M.D.A.

N1 - Funding Information: N.M.D.A. Van Mieghem has received a research grant support from Boston Scientific, Edwards Lifesciences, Abbot Vascular and PulseCath B.V. which were received for activities outside the submitted work. J. Daemen received institutional grant/research support from AstraZeneca, Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, ReCor medical and PulseCath, and consultancy and speaker fees from ACIST medical, Boston Scientific, ReCor Medical, Pie Medical, Medtronic and Pulse Cath. J.F. Ooms, M.L. Geleijnse, E. Spitzer, B. Ren, M.P. Van Wiechen, T.W. Hokken and P.P.T. de Jaegere declare that they have no competing interests. Publisher Copyright: © 2021, The Author(s).

PY - 2021/6/8

Y1 - 2021/6/8

N2 - Background: Functional mitral regurgitation (FMR) can be subclassified based on its proportionality relative to left ventricular function and end-diastolic volume. FMR proportionality could help identify responders to transcatheter edge-to-edge mitral valve repair (MitraClip) in terms of residual FMR and/or clinical improvement. Methods: This single-centre retrospective cohort study evaluated the feasibility of determining FMR proportionality in symptomatic heart failure patients with reduced left ventricular function who were treated with MitraClip for ≥ moderate-to-severe FMR. Baseline proportionate (pFMR) and disproportionate FMR (dFMR) were distinguished. Patient characteristics and MitraClip procedural outcomes were described. Results: From an overall cohort of 81 eligible FMR patients, 23/81 (28%) had to be excluded due to missing transthoracic echocardiogram parameters, 22/81 were excluded based on FMR severity. The remaining cohort, of 36/81 patients (44%), could be classified into dFMR (n = 26) or pFMR (n = 10). Conduction disorders were numerically increased in dFMR. All cases requiring > 2 clips were in the dFMR group and absence of FMR reduction occurred more frequently with dFMR. Point of view/Conclusion: Important limitations in terms of imaging acquisition affect the translation of the FMR proportionality concept to a real-world data set. We did observe different demographic and FMR response patterns in patients with proportionate and disproportionate FMR that warrant further investigation.

AB - Background: Functional mitral regurgitation (FMR) can be subclassified based on its proportionality relative to left ventricular function and end-diastolic volume. FMR proportionality could help identify responders to transcatheter edge-to-edge mitral valve repair (MitraClip) in terms of residual FMR and/or clinical improvement. Methods: This single-centre retrospective cohort study evaluated the feasibility of determining FMR proportionality in symptomatic heart failure patients with reduced left ventricular function who were treated with MitraClip for ≥ moderate-to-severe FMR. Baseline proportionate (pFMR) and disproportionate FMR (dFMR) were distinguished. Patient characteristics and MitraClip procedural outcomes were described. Results: From an overall cohort of 81 eligible FMR patients, 23/81 (28%) had to be excluded due to missing transthoracic echocardiogram parameters, 22/81 were excluded based on FMR severity. The remaining cohort, of 36/81 patients (44%), could be classified into dFMR (n = 26) or pFMR (n = 10). Conduction disorders were numerically increased in dFMR. All cases requiring > 2 clips were in the dFMR group and absence of FMR reduction occurred more frequently with dFMR. Point of view/Conclusion: Important limitations in terms of imaging acquisition affect the translation of the FMR proportionality concept to a real-world data set. We did observe different demographic and FMR response patterns in patients with proportionate and disproportionate FMR that warrant further investigation.

UR - http://www.scopus.com/inward/record.url?scp=85107771111&partnerID=8YFLogxK

U2 - 10.1007/s12471-021-01583-6

DO - 10.1007/s12471-021-01583-6

M3 - Review article

C2 - 34105050

AN - SCOPUS:85107771111

SN - 1568-5888

VL - 29

SP - 359

EP - 364

JO - Netherlands Heart Journal

JF - Netherlands Heart Journal

IS - 7-8

ER -

Transcatheter mitral valve repair in proportionate and disproportionate functional mitral regurgitation—insights from a small cohort study

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