Details

Autor(en) / Beteiligte

• Leone, A M
• Di Giusto, F
• Lucarelli, K
• Vicere, A
• Anastasia, G
• Galante, D
• Petrolati, E
• Burzotta, F
• Aurigemma, C
• Lombardo, A
• Locorotondo, G
• Graziani, F
• Casamassima, V
• Grimaldi, M
• Trani, C

Titel

A novel hemodynamic index characterizing mitral regurgitation undergoing transcatheter edge to edge repair: the mitral pulse pressure fraction

Ist Teil von

• European heart journal, 2023-11, Vol.44 (Supplement_2)

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Objectives Our study sought to investigate the role of invasive hemodynamic monitoring during Transcatheter Edge to Edge Repair (TEER) procedure on top of transesophageal echocardiographic (TEE) guidance. Background Direct hemodynamic impact of residual MR after TEER is not always univocally measured by TEE assessment alone. When analyzing TEER procedure result operators often encounter discrepancy between TEE guidance and invasive hemodynamic monitoring. Methods We analyzed 78 patients with moderate-to-severe or severe mitral regurgitation (MR) who underwent TEER. Mitral pulse Pressure Fraction (MPF) was extracted from intraprocedural continuous left atrial pressure monitoring. 23 patients with the same grade of MR not undergoing TEER were included as a control group. Results TEER had a significant impact reducing MR burden on both TEE guidance and invasive hemodynamic monitoring. Post-TEER MPF was significantly reduced compared to both pre-TEER setting (p < 0.001) and control group (p = 0.004). MR reduction assessed by TEE guidance was not found to be correlated with improved clinical and functional status at follow-up as assessed by New York Heart Association (NYHA) classification (p = 0.424) and 12-items Kansas City Cardiomyopathy Questionnaire (KCCQ) (p = 0.1). On the contrary, a greater reduction in MPF was associated with a significant amelioration of both NYHA classification (p = 0.003) and 12-items KCCQ (p<0.001) during the follow-up period. Conclusions MPF provides an immediate estimate of the real hemodynamic impact of MR and can offer a prompt prediction of the functional improvement after TEER.