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Frequency, predictors, and prognosis of ejection fraction improvement in heart failure: an echocardiogram-based registry study 2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure: A Report of the American College of Cardiology Solution Set Oversight Committee Phenomapping for Novel Classification of Heart Failure With Preserved Ejection Fraction A three-vessel virtual histology intravascular ultrasound analysis of frequency and distribution of thin-cap fibroatheromas in patients with acute coronary syndrome or stable angina pectoris Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies The spectrum of heart failure: value of left ventricular ejection fraction and its moving trajectories DAPT, Our Genome and Clopidogrel Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association
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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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