التفاصيل البيبلوغرافية
| العنوان: |
Regurgitant volume to LA volume ratio in patients with secondary MR: the COAPT trial. |
| المؤلفون: |
Coisne, Augustin, Scotti, Andrea, Granada, Juan F, Grayburn, Paul A, Mack, Michael J, Cohen, David J, Kar, Saibal, Lim, D Scott, Lindenfeld, JoAnn, Bax, Jeroen, Kotinkaduwa, Lak N, Redfors, Björn, Weissman, Neil J, Asch, Federico M, Stone, Gregg W |
| المصدر: |
European Heart Journal - Cardiovascular Imaging; May2024, Vol. 25 Issue 5, p616-625, 10p |
| مصطلحات موضوعية: |
LEFT heart atrium, RESEARCH funding, T-test (Statistics), FISHER exact test, DESCRIPTIVE statistics, CHI-squared test, MANN Whitney U Test, MITRAL valve insufficiency, KAPLAN-Meier estimator, LOG-rank test, CONCEPTUAL structures, DATA analysis software, CONFIDENCE intervals, PROPORTIONAL hazards models |
| مستخلص: |
Aims The conceptual framework of proportionate vs. disproportionate mitral regurgitation (MR) translates poorly to individual patients with heart failure (HF) and secondary MR. A novel index, the ratio of MR severity to left atrial volume (LAV), may identify patients with 'disproportionate' MR and a higher risk of events. The objectives, therefore, were to investigate the prognostic impact of MR severity to LAV ratio on outcomes among HF patients with severe secondary MR randomized to transcatheter edge-to-edge repair (TEER) with the MitraClip™ device plus guideline-directed medical therapy (GDMT) vs. GDMT alone in the COAPT trial. Methods and results The ratio of pre-procedural regurgitant volume (RVol) to LAV was calculated from baseline transthoracic echocardiograms. The primary endpoint was 2-year covariate-adjusted rate of HF hospitalization (HFH). Among 567 patients, the median RVol/LAV was 0.67 (interquartile range 0.48–0.91). In patients randomized to GDMT alone, lower RVol/LAV was independently associated with an increased 2-year risk of HFH (adjHR: 1.77; 95% CI: 1.20–2.63). RVol/LAV was a stronger predictor of adverse outcomes than RVol or LAV alone. Treatment with TEER plus GDMT compared with GDMT alone was associated with lower 2-year rates of HFH both in patients with low and high RVol/LAV (P interaction = 0.28). Baseline RVol/LAV ratio was unrelated to 2-year mortality, health status, or functional capacity in either treatment group. Conclusion Low RVol/LAV ratio was an independent predictor of 2-year HFH in HF patients with severe MR treated with GDMT alone in the COAPT trial. TEER improved outcomes regardless of baseline RVol/LAV ratio. Clinical Trial Registration Trial Name: Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation (The COAPT Trial) (COAPT) ClinicalTrial.gov Identifier NCT01626079 URL https://clinicaltrials.gov/ct2/show/NCT01626079Test [ABSTRACT FROM AUTHOR] |
|
Copyright of European Heart Journal - Cardiovascular Imaging is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder