MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation
Abstract Aims The aim of this study is to evaluate changes in cardiopulmonary exercise test (CPET) after percutaneous mitral valve repair (PMVR) with MitraClip in patients with heart failure with reduced ejection fraction who are potentially candidates for heart transplantation or destination left v...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-08-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.12457 |
| _version_ | 1819204935589298176 |
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| author | Tomás Benito‐González Rodrigo Estévez‐Loureiro Carmen Garrote‐Coloma Ignacio Iglesias Garriz Javier Gualis Laura Álvarez‐Roy Miguel Rodriguez‐Santamarta Armando Pérez de Prado Felipe Fernández‐Vázquez |
| author_facet | Tomás Benito‐González Rodrigo Estévez‐Loureiro Carmen Garrote‐Coloma Ignacio Iglesias Garriz Javier Gualis Laura Álvarez‐Roy Miguel Rodriguez‐Santamarta Armando Pérez de Prado Felipe Fernández‐Vázquez |
| author_sort | Tomás Benito‐González |
| collection | DOAJ |
| description | Abstract Aims The aim of this study is to evaluate changes in cardiopulmonary exercise test (CPET) after percutaneous mitral valve repair (PMVR) with MitraClip in patients with heart failure with reduced ejection fraction who are potentially candidates for heart transplantation or destination left ventricular assist device. Methods and results Prospective registry of all consecutive patients with heart failure with reduced ejection fraction and functional mitral regurgitation (MR) underwent elective PMVR between October 2015 and March 2018 in our institution. Patients with preserved or mid‐range left ventricular ejection fraction (>40%), advanced age (>75 years old), or severe co‐morbidities (end‐stage organ damage) were not included. Treadmill exercise testing with respiratory gas exchange analysis was carried out in 11 patients (male, 72.7%; median age, 67 years old) within the month prior to the procedure and at 6 month follow‐up. PMVR was successfully performed in all patients. At 6 month follow‐up, PMVR was associated with an improvement in New York Heart Association functional class (P = 0.021) and a reduction in MR severity (P = 0.013) and N‐terminal pro‐brain natriuretic peptide levels (2805 [1878–5022] vs. 1485 [654–3032] pg/mL; P = 0.012). All patients completed pre‐procedural and post‐procedural CPET, and all the studies showed a respiratory exchange ratio ≥1 and were consistent with sufficient exercise effort. Compared with pre‐procedural CPET, patients showed a significant increase in exercise time (295 [110–335] vs. 405 [261–540] s; P = 0.047), VO2 (9.8 [9.1–13.4] vs. 13.5 [12.1–16.8] mL/kg/min; P = 0.033), ventilatory anaerobic threshold (510 [430–950] vs. 850 [670–1070] mL/kg/min; P = 0.033), peak O2 pulse (7.2 [4.3–8.6] vs. 8.3 [6.2–11.8] mL/beat; P = 0.033), and workload (5 [3–6] vs. 6 [5–8] metabolic equivalents; P = 0.049). Conclusions Percutaneous mitral valve repair with MitraClip was associated with an enhancement in cardiopulmonary performance in patients with systolic heart failure and secondary MR. |
| first_indexed | 2024-12-23T04:43:43Z |
| format | Article |
| id | doaj.art-52fa96b0d5cc4e0aa70756d04d4cd152 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-23T04:43:43Z |
| publishDate | 2019-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-52fa96b0d5cc4e0aa70756d04d4cd1522022-12-21T17:59:42ZengWileyESC Heart Failure2055-58222019-08-016486787310.1002/ehf2.12457MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitationTomás Benito‐González0Rodrigo Estévez‐Loureiro1Carmen Garrote‐Coloma2Ignacio Iglesias Garriz3Javier Gualis4Laura Álvarez‐Roy5Miguel Rodriguez‐Santamarta6Armando Pérez de Prado7Felipe Fernández‐Vázquez8Department of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainDepartment of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainDepartment of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainDepartment of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainDepartment of Cardiovascular Surgery University Hospital of León León SpainDepartment of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainDepartment of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainDepartment of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainDepartment of Cardiology University Hospital of León Altos de Nava SN 24071 León SpainAbstract Aims The aim of this study is to evaluate changes in cardiopulmonary exercise test (CPET) after percutaneous mitral valve repair (PMVR) with MitraClip in patients with heart failure with reduced ejection fraction who are potentially candidates for heart transplantation or destination left ventricular assist device. Methods and results Prospective registry of all consecutive patients with heart failure with reduced ejection fraction and functional mitral regurgitation (MR) underwent elective PMVR between October 2015 and March 2018 in our institution. Patients with preserved or mid‐range left ventricular ejection fraction (>40%), advanced age (>75 years old), or severe co‐morbidities (end‐stage organ damage) were not included. Treadmill exercise testing with respiratory gas exchange analysis was carried out in 11 patients (male, 72.7%; median age, 67 years old) within the month prior to the procedure and at 6 month follow‐up. PMVR was successfully performed in all patients. At 6 month follow‐up, PMVR was associated with an improvement in New York Heart Association functional class (P = 0.021) and a reduction in MR severity (P = 0.013) and N‐terminal pro‐brain natriuretic peptide levels (2805 [1878–5022] vs. 1485 [654–3032] pg/mL; P = 0.012). All patients completed pre‐procedural and post‐procedural CPET, and all the studies showed a respiratory exchange ratio ≥1 and were consistent with sufficient exercise effort. Compared with pre‐procedural CPET, patients showed a significant increase in exercise time (295 [110–335] vs. 405 [261–540] s; P = 0.047), VO2 (9.8 [9.1–13.4] vs. 13.5 [12.1–16.8] mL/kg/min; P = 0.033), ventilatory anaerobic threshold (510 [430–950] vs. 850 [670–1070] mL/kg/min; P = 0.033), peak O2 pulse (7.2 [4.3–8.6] vs. 8.3 [6.2–11.8] mL/beat; P = 0.033), and workload (5 [3–6] vs. 6 [5–8] metabolic equivalents; P = 0.049). Conclusions Percutaneous mitral valve repair with MitraClip was associated with an enhancement in cardiopulmonary performance in patients with systolic heart failure and secondary MR.https://doi.org/10.1002/ehf2.12457MitraClipCardiopulmonary stress testFunctional mitral regurgitationMaximal O2 consumption |
| spellingShingle | Tomás Benito‐González Rodrigo Estévez‐Loureiro Carmen Garrote‐Coloma Ignacio Iglesias Garriz Javier Gualis Laura Álvarez‐Roy Miguel Rodriguez‐Santamarta Armando Pérez de Prado Felipe Fernández‐Vázquez MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation ESC Heart Failure MitraClip Cardiopulmonary stress test Functional mitral regurgitation Maximal O2 consumption |
| title | MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation |
| title_full | MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation |
| title_fullStr | MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation |
| title_full_unstemmed | MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation |
| title_short | MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation |
| title_sort | mitraclip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation |
| topic | MitraClip Cardiopulmonary stress test Functional mitral regurgitation Maximal O2 consumption |
| url | https://doi.org/10.1002/ehf2.12457 |
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