Our Summary
This study aimed to find out what factors can predict if a heart valve disease called mitral regurgitation (MR) will return after a non-surgical treatment called percutaneous mitral valve repair (PMVR) using a device called MitraClip. This disease was specifically studied in patients who have a type of MR caused by heart failure, known as functional mitral regurgitation (FMR).
The researchers analyzed 306 patients with FMR who underwent PMVR. They considered the treatment successful if the severity of MR was reduced to a certain level at the time of discharge from the hospital. The return of MR was defined as if the disease worsened to a particular level one year after the initial successful treatment.
The treatment was successful in 91.2% of the patients (279 out of 306). However, in 11.4% of these patients, MR returned one year after the successful treatment. Patients who had the disease return also had a higher rate of being rehospitalized due to heart failure in the following year and saw less improvement in their heart failure symptoms.
Patients with returning MR were found to have certain characteristics when compared to patients who maintained long-term success from the treatment. These included a more spherical left ventricle (the chamber of the heart that pumps blood out to the body), a larger left atrium (one of the upper chambers of the heart), a larger ’tenting height’ (a measure of the valve’s shape), and a larger mitral valve (the valve between the left atrium and left ventricle).
When analyzing these factors in a statistical model, the researchers found that a spherical left ventricle, a larger tenting height, and an enlarged left atrium were predictors for the return of MR one year after treatment. Therefore, these factors might help doctors identify which patients are at risk of having their MR return after PMVR treatment.
FAQs
- What is the purpose of the study on mitral regurgitation (MR) and percutaneous mitral valve repair (PMVR)?
- What factors were found to predict the return of MR after PMVR treatment?
- What were the outcomes for patients who had their MR return after successful treatment?
Doctor’s Tip
One helpful tip a doctor might give a patient about mitral valve repair is to maintain regular follow-up appointments to monitor the condition of the mitral valve and ensure early detection of any potential recurrence of mitral regurgitation. Additionally, it may be beneficial for patients to focus on lifestyle modifications such as maintaining a healthy weight, exercising regularly, and managing any underlying conditions such as heart failure to help improve the long-term success of the treatment.
Suitable For
Patients who are typically recommended mitral valve repair are those with functional mitral regurgitation (FMR) caused by heart failure. These patients may have characteristics such as a spherical left ventricle, a larger left atrium, a larger tenting height, and an enlarged mitral valve. These factors can help predict if the disease will return after percutaneous mitral valve repair (PMVR) using a MitraClip device. Identifying these predictors can help doctors determine which patients are at risk of MR returning after treatment and may require additional monitoring or interventions.
Timeline
In summary, before mitral valve repair, a patient with FMR may experience symptoms such as shortness of breath, fatigue, and swelling in the legs. They may undergo diagnostic tests such as echocardiograms and cardiac catheterizations to determine the severity of their condition. Once diagnosed, they may be recommended for PMVR using a MitraClip device.
After the procedure, the patient may experience an improvement in their symptoms and a reduction in the severity of MR. However, there is a risk of MR returning, especially in patients with certain characteristics such as a spherical left ventricle, a larger tenting height, and an enlarged left atrium. These factors can help predict which patients are at risk of MR returning after treatment, allowing for closer monitoring and potentially better outcomes.
What to Ask Your Doctor
Some questions a patient should ask their doctor about mitral valve repair include:
- What is the success rate of percutaneous mitral valve repair (PMVR) with MitraClip for patients with functional mitral regurgitation (FMR)?
- What factors can predict if my MR will return after PMVR treatment?
- How will you assess the severity of my MR before and after the treatment?
- Are there any specific characteristics in my heart’s structure or function that might increase my risk of MR returning after treatment?
- What are the potential complications or risks associated with PMVR treatment?
- How often will I need follow-up appointments to monitor the effectiveness of the treatment?
- What lifestyle changes or medications may be recommended to help maintain the results of the PMVR treatment?
- Are there any alternative treatment options for my FMR that should be considered?
- How will you determine if additional treatments or interventions are needed if my MR returns after PMVR?
- Can you provide more information about the long-term outcomes and prognosis for patients who have undergone PMVR for FMR?
Reference
Authors: Hellhammer K, Haurand JM, Spieker M, Luedike P, Rassaf T, Zeus T, Kelm M, Westenfeld R, Horn P. Journal: Heart Vessels. 2021 Oct;36(10):1574-1583. doi: 10.1007/s00380-021-01828-9. Epub 2021 Apr 3. PMID: 33811553