Ambulatory Pulmonary Artery Pressures After Transcatheter Edge-to-Edge Repair of the Mitral Valve in Patients With Heart Failure and Mitral Regurgitation

Am J Cardiol. 2022 Dec 1:184:90-95. doi: 10.1016/j.amjcard.2022.08.036. Epub 2022 Sep 24.

Abstract

The objective of this study was to assess ambulatory hemodynamics after transcatheter edge-to-edge repair (TEER) of the mitral valve. Pulmonary artery pressure (PAP) measurements from implanted sensors were collected through a remote monitoring database and linked to Medicare fee-for-service claims data. Among patients with linked data, those undergoing TEER were included if the ambulatory PAP monitor was implanted ≥3 months before TEER and ≥3 months of PAP data after TEER were available. The primary end point was diastolic PAP (dPAP) at 3 months after TEER compared with baseline. A total of 50 patients undergoing TEER between July 2014 and March 2020 were included, with an average age of 75 ± 8 years and 70% were men. dPAP was significantly lower at 3 months after TEER than baseline, -1.8 ± 4.8 mm Hg, p = 0.010. The cumulative reduction in dPAP (area under the curve) was significantly lower at 3 months after TEER, 113 ± 267 mm Hg-days, p = 0.004. A reduction in dPAP at 3 months after TEER was independently associated with a significantly lower risk of heart failure hospitalization (p = 0.023). TEER of the mitral valve is associated with a clinically relevant and sustained reduction in dPAP.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiac Catheterization
  • Female
  • Heart Failure* / complications
  • Heart Valve Prosthesis Implantation*
  • Humans
  • Male
  • Medicare
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency* / complications
  • Mitral Valve Insufficiency* / surgery
  • Pulmonary Artery
  • Treatment Outcome
  • United States / epidemiology