Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair
Background. Limited data exist regarding the association between the quality of life (QoL) and clinical outcomes following transcatheter mitral valve repair (TMVr). We aimed to evaluate the prognostic significance of QoL assessment following TMVr and to characterize those who had procedural success,...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi-Wiley
2023-01-01
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| Series: | International Journal of Clinical Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/1977911 |
| _version_ | 1797871530175102976 |
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| author | Sharon Shalom Natanzon Keita Koseki Danon Kaewkes Ofir Koren Vivek Patel Mamoo Nakamura Tarun Chakravarty Raj Makkar |
| author_facet | Sharon Shalom Natanzon Keita Koseki Danon Kaewkes Ofir Koren Vivek Patel Mamoo Nakamura Tarun Chakravarty Raj Makkar |
| author_sort | Sharon Shalom Natanzon |
| collection | DOAJ |
| description | Background. Limited data exist regarding the association between the quality of life (QoL) and clinical outcomes following transcatheter mitral valve repair (TMVr). We aimed to evaluate the prognostic significance of QoL assessment following TMVr and to characterize those who had procedural success, yet reported a low Kansas City Cardiomyopathy Questionnaire (KCCQ-12) score. Methods. We reported the experience of Cedars-Sinai Medical Center patients between 2013 and 2020. Patients were allocated into four groups according to the 30-day KCCQ: <25, 25–49, 50–74, and ≥75. Primary outcome included 1-year all-cause death or heart failure (HF) hospitalizations. We also examined the association between QoL and the primary outcome in those with procedural success. Results. A total of 555 patients were included in our analysis, median follow-up of 650 days (IQR 243–1113). The lower KCCQ groups had a higher prevalence of functional mitral regurgitation (65%, 60%, 56%, and 43%, p=0.001), as well as a higher Society of Thoracic Surgeon (STS) score. These groups had a significantly higher occurrence of 1-year all-cause death or HF hospitalizations in a stepwise fashion (40%, 22%, 16%, and 10%, p<0.001). Multivariable Cox regression analysis revealed 30-day KCCQ as the strongest predictor of the 1-year primary outcome (HR 0.98, 95%CI (0.97–0.99), p=0.006). Approximately a quarter of patients with procedural success had a low KCCQ score. These patients had a higher rate of the combined 1-year outcome regardless of procedural success or failure. Conclusion. QoL following TMVr is a powerful prognostic factor. KCCQ assessment is an important indicator for identifying patients prone to adverse outcomes even after procedural success. |
| first_indexed | 2024-04-10T00:45:19Z |
| format | Article |
| id | doaj.art-b08ac8dfbf064142826451e8e01482e8 |
| institution | Directory Open Access Journal |
| issn | 1742-1241 |
| language | English |
| last_indexed | 2024-04-10T00:45:19Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi-Wiley |
| record_format | Article |
| series | International Journal of Clinical Practice |
| spelling | doaj.art-b08ac8dfbf064142826451e8e01482e82023-03-14T00:00:05ZengHindawi-WileyInternational Journal of Clinical Practice1742-12412023-01-01202310.1155/2023/1977911Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve RepairSharon Shalom Natanzon0Keita Koseki1Danon Kaewkes2Ofir Koren3Vivek Patel4Mamoo Nakamura5Tarun Chakravarty6Raj Makkar7Cedars-Sinai Medical CenterCedars-Sinai Medical CenterCedars-Sinai Medical CenterCedars-Sinai Medical CenterCedars-Sinai Medical CenterCedars-Sinai Medical CenterCedars-Sinai Medical CenterCedars-Sinai Medical CenterBackground. Limited data exist regarding the association between the quality of life (QoL) and clinical outcomes following transcatheter mitral valve repair (TMVr). We aimed to evaluate the prognostic significance of QoL assessment following TMVr and to characterize those who had procedural success, yet reported a low Kansas City Cardiomyopathy Questionnaire (KCCQ-12) score. Methods. We reported the experience of Cedars-Sinai Medical Center patients between 2013 and 2020. Patients were allocated into four groups according to the 30-day KCCQ: <25, 25–49, 50–74, and ≥75. Primary outcome included 1-year all-cause death or heart failure (HF) hospitalizations. We also examined the association between QoL and the primary outcome in those with procedural success. Results. A total of 555 patients were included in our analysis, median follow-up of 650 days (IQR 243–1113). The lower KCCQ groups had a higher prevalence of functional mitral regurgitation (65%, 60%, 56%, and 43%, p=0.001), as well as a higher Society of Thoracic Surgeon (STS) score. These groups had a significantly higher occurrence of 1-year all-cause death or HF hospitalizations in a stepwise fashion (40%, 22%, 16%, and 10%, p<0.001). Multivariable Cox regression analysis revealed 30-day KCCQ as the strongest predictor of the 1-year primary outcome (HR 0.98, 95%CI (0.97–0.99), p=0.006). Approximately a quarter of patients with procedural success had a low KCCQ score. These patients had a higher rate of the combined 1-year outcome regardless of procedural success or failure. Conclusion. QoL following TMVr is a powerful prognostic factor. KCCQ assessment is an important indicator for identifying patients prone to adverse outcomes even after procedural success.http://dx.doi.org/10.1155/2023/1977911 |
| spellingShingle | Sharon Shalom Natanzon Keita Koseki Danon Kaewkes Ofir Koren Vivek Patel Mamoo Nakamura Tarun Chakravarty Raj Makkar Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair International Journal of Clinical Practice |
| title | Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair |
| title_full | Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair |
| title_fullStr | Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair |
| title_full_unstemmed | Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair |
| title_short | Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair |
| title_sort | quality of life procedural success and clinical outcomes following transcatheter mitral valve repair |
| url | http://dx.doi.org/10.1155/2023/1977911 |
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