Antonio Popolo Rubbio1, MD; Antonio Sisinni1, MD; Alice Moroni1, MD; Marianna Adamo2, MD; Carmelo Grasso3, MD; Matteo Casenghi1, MD; Maurizio B. Tusa1, MD; Marta Barletta1, MD; Paolo Denti4, MD; Arturo Giordano5, MD; Federico De Marco6, MD; Antonio L Bartorelli7, MD; Matteo Montorfano8, MD; Cosmo Godino9, MD; Eustachio Agricola9, MD; Rodolfo Citro10,11, MD; Francesco De Felice12, MD; Annalisa Mongiardo13, MD; Ida Monteforte14, MD; Emmanuel Villa15, MD; Anna Sonia Petronio16, MD; Cristina Giannini16, MD; Gabriele Crimi17, MD; Giulia Masiero18, MD; Giuseppe Tarantini18, MD; Luca Testa1, MD, PhD; Corrado Tamburino3, MD; Francesco Bedogni1, MD; on behalf of the GIOTTO registry
1. Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; 2. Cardiac Catheterisation Laboratory and Cardiology, ASST Spedali Civili di Brescia, Brescia, Italy and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; 3. Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), AOU Policlinico “G. Rodolico – S. Marco”, University of Catania, Catania, Italy; 4. Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy; 5. Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy; 6. Centro Cardiologico Monzino, IRCCS, Milan, Italy; 7. Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; 8. School of Medicine, Vita-Salute San Raffaele University, Milan, Italy and Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; 9. Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, Vita- Salute University, San Raffaele Hospital, IRCCS, Milan, Italy; 10. University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy; 11. Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy; 12. Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy; 13. Division of Cardiology, University Magna Graecia, Catanzaro, Italy; 14. AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy; 15. Valve Center, Poliambulanza Foundation Hospital, Brescia, Italy; 16. Cardiac Catheterisation Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy; 17. Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 18. Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit, University of Padua, Padua, Italy
Background: In the context of primary mitral regurgitation (PMR), the selection of patients for transcatheter edge-to-edge repair (TEER) does not include a systematic assessment of PMR-associated cardiac remodelling.
Aims: We aimed to investigate the epidemiology and prognostic significance of different phenotypes of extra-mitral valve (MV) cardiac involvement in a large series of patients with PMR referred for TEER.
Methods: The study included 654 patients from the multicentre Italian GIOTTO registry, stratified into groups according to extra-mitral valve (MV) cardiac involvement. The primary endpoint was all-cause death at 2-year follow-up.
Results: Patients with no cardiac involvement (NI; n=58), left heart involvement (LHI; n=343) and right heart involvement (RHI; n=253) were analysed. Acute technical success was achieved in 98% of patients. Kaplan-Meier curve analysis revealed significantly worse survival in patients with LHI and RHI (p=0.041). On multivariate Cox regression analysis, extra-MV cardiac involvement, haemoglobin level and technical success were independent predictors of the primary endpoint occurrence.
Conclusions: Grading cardiac involvement may help refine risk stratification, since at least 1 group of extra-MV cardiac involvement represents in itself a negative predictor of midterm outcome.
No account yet? Create my pcr account
Sign up for free!
Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases
mitral regurgitationmitral valve diseasemitral valve repair
Read next article
First-in-human study of the CAPTIS embolic protection system during transcatheter aortic valve replacement