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MitraClip shows promise in patients with CRT, severe MR
The MitraClip percutaneous device was associated with improved N-terminal pro-brain natriuretic peptide levels in a cohort of patients with a cardiac resynchronization therapy device and severe mitral regurgitation, according to recent findings.
The researchers noted that mitral regurgitation ≥3+ and left ventricular dyssynchrony among patients with HF may signify failure of response to cardiac resynchronization therapy (CRT), and that the MitraClip (Abbott Vascular) may be effective in patients with high surgical risk.
The current analysis included 42 patients at a single center. Clinicians compared 1-year and 2-year mortality outcomes with those predicted by the Seattle Heart Failure Model and the Meta-Analysis Global Group in Chronic Heart Failure using baseline data from when the device was implanted.
Between CRT and implantation of the device, a median of 20.1 months (4.5-43.3) elapsed.
Nineteen patients demonstrated functional regurgitation with normal leaflets, according to the results. A degenerative mechanism for mitral regurgitation was reported in 23 patients.
The researchers did not observe a change in mean QRS duration by biventricular pacing or implantation of the MitraClip device. A number of reductions were reported in association with the device, including a decrease in median N-terminal pro-brain natriuretic peptide levels (pg/mL) from 3,923 to 2,636 (P=.02) and tricuspid regurgitation pressure gradient from 43 mm Hg to 35 mm Hg (P=.019). A reduction also occurred in LV end-diastolic volume with the MitraClip (P=.008).
An all-cause mortality rate of 25% was reported at the 2-year follow-up.
The researchers concluded that the mortality rate was not significantly different from the rate predicted by the two predictive models.
Disclosure: The researchers report financial disclosures with Abbott Vascular.