Outcomes of mitral TEER in non-responders to cardiac resynchronization therapy: A systematic review and meta-analysis

IF 2.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of cardiology Pub Date : 2024-05-16 DOI:10.1016/j.jjcc.2024.05.005

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引用次数: 0

Abstract

Background

Secondary mitral regurgitation (MR) worsens in 10–15 % of heart failure (HF) patients receiving cardiac resynchronization therapy (CRT). Transcatheter edge-to-edge repair (TEER) with Mitra-Clip (Abbot Vascular, Santa Clara, CA, USA) therapy is associated with improved survival and decreased rates of hospitalization for HF in selected patients with secondary MR. Data on TEER outcomes in CRT-non-responders are limited. The purpose of this meta-analysis was to evaluate outcomes of mitral TEER with Mitra-Clip in CRT-non-responders.

Methods

Cochrane, Scopus, MEDLINE, and EMBASE were searched for studies discussing outcomes of Mitra-Clip in CRT non-responders. Two reviewers were independently involved in screening studies and extracting relevant data. Individual study incidence rate estimates underwent logit transformation to calculate the weighted summary proportion under the random effect model.

Results

A total of eight reports met the inclusion criteria (439 patients). Mitra-Clip improved MR grade to ≤2+ in 83.8 % and 86.8 % of CRT non-responders at six months and one year, respectively. Symptomatic improvement (New York Heart Association class ≤II) was also found in 71 % and 78.1 % of CRT non-responders at six months and one year, respectively. The pooled overall incidence estimates of mortality at 30 days, 6 months, 1 year, and 2 years were 3.6 %, 9.2 %, 17.8 %, and 25.9 %, respectively.

Conclusion

TEER with Mitra-Clip in patients with significant secondary MR who do not respond to CRT was associated with MR improvement, alleviation of symptoms, and mortality rates similar to those in the COAPT trial.

Abstract Image

查看原文本刊更多论文

心脏再同步化疗法无应答者二尖瓣 TEER 的疗效：系统回顾与元分析。

背景：在接受心脏再同步化治疗（CRT）的心力衰竭（HF）患者中，10%-15%的患者会出现继发性二尖瓣反流（MR）。使用 Mitra-Clip （Abbot Vascular，Santa Clara，CA，USA）治疗经导管边缘到边缘修补术（TEER）可提高继发性二尖瓣反流患者的生存率，降低因心衰住院的比例。有关 TEER 在 CRT 无应答患者中疗效的数据很有限。本荟萃分析的目的是评估二尖瓣 TEER 与 Mitra-Clip 在 CRT 无应答患者中的疗效：方法：在 Cochrane、Scopus、MEDLINE 和 EMBASE 中检索讨论 CRT 无应答者 Mitra-Clip 治疗效果的研究。两名审稿人独立参与筛选研究并提取相关数据。在随机效应模型下，对单项研究的发病率估计值进行对数转换，以计算加权汇总比例：共有8篇报告符合纳入标准（439名患者）。六个月和一年后，83.8%和86.8%的CRT无反应者的MR分级分别被Mitra-Clip改善至≤2+。六个月和一年后，分别有 71% 和 78.1% 的 CRT 无应答患者的症状得到改善（纽约心脏协会分级≤II）。30天、6个月、1年和2年的总死亡率估计值分别为3.6%、9.2%、17.8%和25.9%：对于对 CRT 无反应的严重继发性 MR 患者，使用 Mitra-Clip 的 TEER 与 MR 改善、症状缓解和死亡率相关，与 COAPT 试验的结果相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

8.00%

发文量

202

审稿时长

29 days

期刊介绍： The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.