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Disturbed shear stress promotes atherosclerosis through TRIM21-regulated MAPK6 degradation and consequent endothelial inflammation Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label，blinded-outcome，randomised trial
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Original Research2020 Dec 16;e13473.

JOURNAL：Eur J Clin Invest . Article Link

Initial experience with percutaneous mitral valve repair in patients with cardiac amyloidosis

MJ Volz, ST Pleger, A Weber et al. Keywords: PMVR; amyloid cardiomyopathy; cardiac amyloidosis; mitral regurgitation

ABSTRACT

BACKGROUND - Percutaneous mitral valve repair (PMVR) is a therapeutic option for severe mitral regurgitation (MR) in patients with heart failure due to differential etiologies. However, only little is known about the safety and efficacy of this procedure in patients with amyloid cardiomyopathy.


METHODS - Five Patients with cardiac amyloidosis and moderate to severe or severe MR undergoing PMVR were analyzed retrospectively and compared to seven patients with cardiac amyloidosis and severe MR without intervention. Clinical and functional data, renal function and cardiac biomarkers as well as established risk scores for cardiac amyloidosis were assessed. Primary endpoint was the reduction in MR one year after PMVR. Secondary endpoints were safety, overall mortality after 12 months compared to the control group, as well as changes in clinical and functional parameters.


RESULTS - Amyloidosis risk assessment documented amyloid cardiomyopathy at an advanced stage in all patients. Procedural, technical and device success of PMVR were all 100% and residual MR remained mild to moderate at 12 months follow‐up (p=0.038 vs. before PMVR). Differences in survival compared to the control (no PMVR) group pointed to a possible survival benefit in the PMVR group (p= 0.02).


CONCLUSION - PMVR is a feasible and safe procedure in patients with cardiac amyloidosis and might carry a possible survival benefit in this patient group.

 



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