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Impact of left ventricular systolic dysfunction on the outcomes of percutaneous edge-to-edge mitral valve repair using MitraClip

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Abstract

Left ventricular systolic dysfunction (LVD) is associated with poor outcomes after mitral regurgitation (MR) surgery. MitraClip (MC) is a novel treatment option for MR patients with a high surgical risk. However, outcomes of LVD patients underwent MC remain unclear. In total of 194 patients after MC implantation, 75 patients (39 %) had severe LVD (LV ejection fraction ≤30 %). Patients with severe LVD were primarily male and also younger. Logistic euroSCOREs were comparable between the two groups. Functional MR was more common in patients with severe LVD, while New York Heart Association (NYHA) class was similar between the two groups. N-terminal pro-B-type natriuretic peptide (NT-proBNP) was significantly higher in patients with LVD. In addition to similar improvements in MR severity, NYHA class, and NT-proBNP levels, the survival rates were not different between patients with and without severe LVD. Among patients with severe LVD, the long-term survival rates were significantly lower in patients aged ≥75 years, those with NT-proBNP >5000 pg/mL, and those with atrial fibrillation (AF). In conclusion, severe LVD was not associated with the mortality after MC implantation. MC might be feasible and effective even in the patients with severe MR and low LVEF. However, we need to carefully observe severe LVD patients who are elderly, have a high NT-proBNP level, and have AF, as these might be considered high-risk subjects.

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    Authors and Affiliations

    1. Department of Cardiology, Heart Center Brandenburg, Bernau, Germany

      Hidehiro Kaneko, Michael Neuss, Thomas Schau, Jens Weissenborn & Christian Butter

    2. Department of Cardiology, Medical School Brandenburg, Ladeburger Straße 17, 16321, Bernau, Germany

      Hidehiro Kaneko, Michael Neuss, Thomas Schau, Jens Weissenborn & Christian Butter

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    1. Hidehiro Kaneko
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    2. Michael Neuss
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    Correspondence to Christian Butter.

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    Conflict of interest

    Christian Butter and Michael Neuss received lecture honoraria and Christian Butter, Michael Neuss and Thomas Schau travel grants from Abbott Laboratories, Abbott Park, Illinois, USA.

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    This work was supported by the Japan Society for the Promotion of Science (Hidehiro Kaneko).

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    H. Kaneko and M. Neuss contributed equally to this publication (share first authorship).

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    Kaneko, H., Neuss, M., Schau, T. et al. Impact of left ventricular systolic dysfunction on the outcomes of percutaneous edge-to-edge mitral valve repair using MitraClip. Heart Vessels 31, 1988–1996 (2016). https://doi.org/10.1007/s00380-016-0822-1

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    • DOI: https://doi.org/10.1007/s00380-016-0822-1

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