Pulmonary artery pressures and outcomes after MitraClip

Yonatan Rashi; Dan Haberman; Ivaylo Tonchev; Alona Peretz; Anna Turyan Medvedovsky; Israel Gotsman; Saar Minha; Lion Poles; Sara Shimoni; Sorel Goland; Gidon Y. Perlman; Haim D. Danenberg; Ronen Beeri; Mony Shuvy

doi:10.1002/ehf2.13018

Pulmonary artery pressures and outcomes after MitraClip

Yonatan Rashi, Dan Haberman^*, Ivaylo Tonchev, Alona Peretz, Anna Turyan Medvedovsky, Israel Gotsman, Saar Minha, Lion Poles, Sara Shimoni, Sorel Goland, Gidon Y. Perlman, Haim D. Danenberg, Ronen Beeri, Mony Shuvy

^*Corresponding author for this work

Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

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Abstract

Aims: We evaluated the impact of MitraClip on systolic pulmonary artery pressure (sPAP) and the effects of baseline sPAP on outcomes. Methods and results: In a cohort of patients who underwent MitraClip implantation, three groups were defined according to pre-procedure sPAP levels. Clinical and echocardiographic data were compared. The study included 177 patients: 59 had severe pulmonary hypertension (PHT), 96 had mild to moderate PHT, and 22 had no PHT. In patients with pre-existing severe PHT, sPAP was reduced from 70.8 ± 9.2 to 56.8 ± 13.7 mmHg (P < 0.001), sPAP remained unchanged in patients with mild to moderate PHT but was significantly increased from 30.8 ± 4.3 to 38.6 ± 8.3 mmHg in the no-PHT group (P < 0.001). Improvement of sPAP was observed in 77% of severe PHT group, while worsening of sPAP was more common among patients with no-PHT [57% compared with 33% among the mild to moderate PHT and 7% in the severe PHT group, respectively, (P < 0.001)]. One year survival was similar among the study groups. Conclusions: MitraClip decreases PHT among patients with severe PHT. A concerning finding is that most patients with no-PHT increase their sPAP.

Original language	English
Pages (from-to)	4071-4079
Number of pages	9
Journal	ESC heart failure
Volume	7
Issue number	6
DOIs	https://doi.org/10.1002/ehf2.13018
State	Published - Dec 2020

Bibliographical note

Publisher Copyright:
© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology

Keywords

Heart failure
MitraClip
Mitral regurgitation
Pulmonary hypertension
Transcatheter mitral valve repair

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10.1002/ehf2.13018

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title = "Pulmonary artery pressures and outcomes after MitraClip",

abstract = "Aims: We evaluated the impact of MitraClip on systolic pulmonary artery pressure (sPAP) and the effects of baseline sPAP on outcomes. Methods and results: In a cohort of patients who underwent MitraClip implantation, three groups were defined according to pre-procedure sPAP levels. Clinical and echocardiographic data were compared. The study included 177 patients: 59 had severe pulmonary hypertension (PHT), 96 had mild to moderate PHT, and 22 had no PHT. In patients with pre-existing severe PHT, sPAP was reduced from 70.8 ± 9.2 to 56.8 ± 13.7 mmHg (P < 0.001), sPAP remained unchanged in patients with mild to moderate PHT but was significantly increased from 30.8 ± 4.3 to 38.6 ± 8.3 mmHg in the no-PHT group (P < 0.001). Improvement of sPAP was observed in 77% of severe PHT group, while worsening of sPAP was more common among patients with no-PHT [57% compared with 33% among the mild to moderate PHT and 7% in the severe PHT group, respectively, (P < 0.001)]. One year survival was similar among the study groups. Conclusions: MitraClip decreases PHT among patients with severe PHT. A concerning finding is that most patients with no-PHT increase their sPAP.",

keywords = "Heart failure, MitraClip, Mitral regurgitation, Pulmonary hypertension, Transcatheter mitral valve repair",

author = "Yonatan Rashi and Dan Haberman and Ivaylo Tonchev and Alona Peretz and Medvedovsky, {Anna Turyan} and Israel Gotsman and Saar Minha and Lion Poles and Sara Shimoni and Sorel Goland and Perlman, {Gidon Y.} and Danenberg, {Haim D.} and Ronen Beeri and Mony Shuvy",

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doi = "10.1002/ehf2.13018",

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T1 - Pulmonary artery pressures and outcomes after MitraClip

AU - Rashi, Yonatan

AU - Haberman, Dan

AU - Tonchev, Ivaylo

AU - Peretz, Alona

AU - Medvedovsky, Anna Turyan

AU - Gotsman, Israel

AU - Minha, Saar

AU - Poles, Lion

AU - Shimoni, Sara

AU - Goland, Sorel

AU - Perlman, Gidon Y.

AU - Danenberg, Haim D.

AU - Beeri, Ronen

AU - Shuvy, Mony

PY - 2020/12

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N2 - Aims: We evaluated the impact of MitraClip on systolic pulmonary artery pressure (sPAP) and the effects of baseline sPAP on outcomes. Methods and results: In a cohort of patients who underwent MitraClip implantation, three groups were defined according to pre-procedure sPAP levels. Clinical and echocardiographic data were compared. The study included 177 patients: 59 had severe pulmonary hypertension (PHT), 96 had mild to moderate PHT, and 22 had no PHT. In patients with pre-existing severe PHT, sPAP was reduced from 70.8 ± 9.2 to 56.8 ± 13.7 mmHg (P < 0.001), sPAP remained unchanged in patients with mild to moderate PHT but was significantly increased from 30.8 ± 4.3 to 38.6 ± 8.3 mmHg in the no-PHT group (P < 0.001). Improvement of sPAP was observed in 77% of severe PHT group, while worsening of sPAP was more common among patients with no-PHT [57% compared with 33% among the mild to moderate PHT and 7% in the severe PHT group, respectively, (P < 0.001)]. One year survival was similar among the study groups. Conclusions: MitraClip decreases PHT among patients with severe PHT. A concerning finding is that most patients with no-PHT increase their sPAP.

AB - Aims: We evaluated the impact of MitraClip on systolic pulmonary artery pressure (sPAP) and the effects of baseline sPAP on outcomes. Methods and results: In a cohort of patients who underwent MitraClip implantation, three groups were defined according to pre-procedure sPAP levels. Clinical and echocardiographic data were compared. The study included 177 patients: 59 had severe pulmonary hypertension (PHT), 96 had mild to moderate PHT, and 22 had no PHT. In patients with pre-existing severe PHT, sPAP was reduced from 70.8 ± 9.2 to 56.8 ± 13.7 mmHg (P < 0.001), sPAP remained unchanged in patients with mild to moderate PHT but was significantly increased from 30.8 ± 4.3 to 38.6 ± 8.3 mmHg in the no-PHT group (P < 0.001). Improvement of sPAP was observed in 77% of severe PHT group, while worsening of sPAP was more common among patients with no-PHT [57% compared with 33% among the mild to moderate PHT and 7% in the severe PHT group, respectively, (P < 0.001)]. One year survival was similar among the study groups. Conclusions: MitraClip decreases PHT among patients with severe PHT. A concerning finding is that most patients with no-PHT increase their sPAP.

KW - Heart failure

KW - MitraClip

KW - Mitral regurgitation

KW - Pulmonary hypertension

KW - Transcatheter mitral valve repair

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ER -

Pulmonary artery pressures and outcomes after MitraClip

Abstract

Bibliographical note

Keywords

UN SDGs

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