AI Article Synopsis
- Tricuspid regurgitation (TR) in patients with mitral valve disease is linked to worse functional outcomes and higher mortality rates, especially in those with TR grades greater than II.
- In a study of 261 patients undergoing MitraClip procedures, improvements in functional class and walking distance were only significant in those with TR grades of II or below.
- Patients with higher TR grades experienced increased NT-pro-BNP levels and had a 2.04 times higher risk of mortality, indicating the need for targeted treatments for TR in symptomatic mitral regurgitation cases.
Article Abstract
Aims: Tricuspid regurgitation (TR) in patients with mitral valve disease is associated with poor outcome and mortality. Only limited data on the impact of TR on functional outcome and survival in patients undergoing MitraClip procedures are available.
Methods And Results: 261 patients (mean age 76.6 ± 10, EuroScore 15.9 ± 15.1%) with symptomatic mitral regurgitation (MR) (75.2% functional MR) undergoing MitraClip procedure were included and followed for 721 ± 19.4 days. At baseline 54.7% presented with TR grade 0/I, 29.5% with grade II, 13.4% with grade III and 2.3% with grade IV. When dividing groups according to baseline TR grades, follow-up (FU)-NYHA class was significantly improved only in patients with TR ≤ II (p = 0.05). FU-6-min walking distance increased significantly in the overall cohort (p = 0.05), in patients with TR ≤ II (p = 0.007), but not in patients with TR > II (p = 0.4). Moreover, FU-NT-pro-BNP levels were higher in patients with TR > II (p = 0.05), compared to patients with TR ≤ II. There was a higher mortality according to baseline TR > II and multivariate Cox regression revealed TR > II as the strongest independent predictor for mortality (hazard ratio 2.04).
Conclusions: Concomitant TR at baseline negatively influences functional outcome and mortality in patients undergoing MitraClip procedures. Our results underline the need for dedicated interventional strategies for the treatment of TR in patients with symptomatic MR.
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| http://dx.doi.org/10.1007/s00392-016-1062-1 | DOI Listing |
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