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Invasive Management of Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Scientific Statement From the American Heart Association Transcatheter Mitral-Valve Repair in Patients with Heart Failure Refractory Angina: From Pathophysiology to New Therapeutic Nonpharmacological Technologies Randomized Comparison of Ridaforolimus-Eluting and Zotarolimus-Eluting Coronary Stents 2-Year Clinical Outcomes: From the BIONICS and NIREUS Trials Effect of Empagliflozin on Cardiovascular and Renal Outcomes in Patients With Heart Failure by Baseline Diabetes Status - Results from the EMPEROR-Reduced Trial Incidence, predictors, and outcomes of DAPT disruption due to non-compliance vs. bleeding after PCI: insights from the PARIS Registry Randomized Comparison Between Radial and Femoral Large-Bore Access for Complex Percutaneous Coronary Intervention Prevalence, Presentation and Treatment of 'Balloon Undilatable' Chronic Total Occlusions: Insights from a Multicenter US Registry State of the Art in Noninvasive Imaging of Ischemic Heart Disease and Coronary Microvascular Dysfunction in Women: Indications, Performance, and Limitations Complete Revascularization with Multivessel PCI for Myocardial Infarction

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 followup (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.