MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation

Benito‐González, Tomas; Estévez‐Loureiro, Rodrigo; Garrote‐Coloma, Carmen; Iglesias-Garriz, Ignacio; Gualis, Javier; Álvarez-Roy, Laura; Rodríguez-Santamarta, Miguel; Prado, Armando Pérez de; Fernández‐Vázquez, Felipe

doi:10.1002/ehf2.12457

Cited by 11 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…And regarding patients with advanced HF, COAPT showed as well that MitraClip can lead to a reduction in the heart transplant or LVAD implantation rate. This finding, together with other positive data coming from registries, such as reverse remodeling, decrease in arrhythmic burden or improvement in O 2 consumption may prompt the indication in patients with LVD and advanced heart failure (36,(39)(40)(41)(42).…”

Section: Percutaneous Edge-to-edge Mitral Valve Repair (Pmvr)mentioning

confidence: 60%

Percutaneous mitral repair: current and future devices

et al. 2020

View full text Add to dashboard Cite

Mitral regurgitation (MR) is the second most common valvular heart disease and its prevalence is increasing with population ageing. In the recent years we have witnessed the development of several transcatheter devices to correct MR in patients at high-risk for surgery. The majority of evidence regarding safety and efficacy of this new therapy comes from MitraClip studies. However, new alternatives on the field of valve repair have emerged with promising results. The aim of this review is to portrait the landscape of transcatheter mitral repair alternatives, from currently used devices to those that will have a role in the near future.

show abstract

Section: Percutaneous Edge-to-edge Mitral Valve Repair (Pmvr)mentioning

confidence: 60%

Percutaneous mitral repair: current and future devices

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Patients with functional MVR who underwent TEER showed an improvement in CPET parameters, including the peak VO 2 , likely due to the increase in anterograde stroke volume, decrease in pulmonary pressures, and reverse remodelling of the LV [81,82]. On the contrary, it has been reported that individuals affected by degenerative or secondary MVR treated with TEER did not exhibit an increase in peak VO 2 despite the improvement in cardiac output [83].…”

Section: Percutaneous Mitral Valve Interventionsmentioning

confidence: 94%

An Overview of Sport Participation and Exercise Prescription in Mitral Valve Disease

Perone¹,

Peruzzi

Conte

et al. 2023

JCDD

View full text Add to dashboard Cite

The incidence of heart valve disease (HVD) has been rising over the last few decades, mainly due to the increasing average age of the general population, and mitral valve (MV) disease is the second most prevalent HVD after calcific aortic stenosis, but MV disease is a heterogeneous group of different pathophysiological diseases. It is widely proven that regular physical activity reduces all-cause mortality rates, and exercise prescription is part of the medical recommendations for patients affected by cardiovascular diseases. However, changes in hemodynamic balance during physical exercise (including the increase in heart rate, preload, or afterload) could favor the progression of the MV disease and potentially trigger major cardiac events. In young patients with HVD, it is therefore important to define criteria for allowing competitive sport or exercise prescription, balancing the positive effects as well as the potential risks. This review focuses on mitral valve disease pathophysiology, diagnosis, risk stratification, exercise prescription, and competitive sport participation selection, and offers an overview of the principal mitral valve diseases with the aim of encouraging physicians to embody exercise in their daily practice when appropriate.

show abstract

“…On top of the MITRA‐FR and the COAPT trials, which mainly focused on pMVR‐induced changes in prognosis, 6,7 several other studies were published on the efficacy of pMVR. Overall, these studies suggest that pMVR treatment is associated with an improvement in symptoms, quality of life, functional status and, in some but not all studies, exercise capacity 8–12 . Indeed, although MR directly impairs exercise performance, 13 both the COAPT and the MITRA‐FR trials reported a null effect of pMVR on the 6‐min walk test (6MWT) 6,7,14 .…”

Section: Introductionmentioning

confidence: 92%

“…Overall, these studies suggest that pMVR treatment is associated with an improvement in symptoms, quality of life, functional status and, in some but not all studies, exercise capacity. 8 , 9 , 10 , 11 , 12 Indeed, although MR directly impairs exercise performance, 13 both the COAPT and the MITRA‐FR trials reported a null effect of pMVR on the 6‐min walk test (6MWT). 6 , 7 , 14 Differently, several other studies suggested an improved exercise performance, 11 , 15 assessed in the great majority of reports by 6MWT.…”

Section: Introductionmentioning

confidence: 99%

Rest and exercise oxygen uptake and cardiac output changes 6 months after successful transcatheter mitral valve repair

et al. 2021

View full text Add to dashboard Cite

Aims Changes in peak exercise oxygen uptake (VO2) and cardiac output (CO) 6 months after successful percutaneous edge‐to‐edge mitral valve repair (pMVR) in severe primary (PMR) and functional mitral regurgitation (FMR) patients are unknown. The aim of the study was to assess the efficacy of pMVR at rest by echocardiography, VO2 and CO (inert gas rebreathing) measurement and during cardiopulmonary exercise test with CO measurement. Methods and results We evaluated 145 and 115 patients at rest and 98 and 66 during exercise before and after pMVR, respectively. After successful pMVR, significant reductions in MR and NYHA class were observed in FMR and PMR patients. Cardiac ultrasound showed reverse remodelling (left ventricular end‐diastolic volume from 158 ± 63 mL to 147 ± 64, P < 0.001; ejection fraction from 51 ± 15 to 48 ± 14, P < 0.001; pulmonary artery systolic pressure (PASP) from 43 ± 13 to 38 ± 8 mmHg, P < 0.001) in the entire population. These changes were significant in PMR (n = 62) and a trend in FMR (n = 53), except for PASP, which decreased in both groups. At rest, CO and stroke volume (SV) increased in FMR with a concomitant reduction in arteriovenous O2 content difference [ΔC(a‐v)O2]. Peak exercise, CO and SV increased significantly in both groups (CO from 5.5 ± 1.4 L/min to 6.3 ± 1.5 and from 6.2 ± 2.4 to 6.7 ± 2.0, SV from 57 ± 19 mL to 66 ± 20 and from 62 ± 20 to 69 ± 20, in FMR and PMR, respectively), whereas peak VO2 was unchanged and ΔC(a‐v)O2 decreased. Conclusions These data confirm pMVR‐induced clinical improvement and reverse ventricular remodelling at a 6‐month analysis and show, in spite of an increase in CO, an unchanged exercise performance, which is achieved through a ‘more physiological’ blood flow distribution and O2 extraction behaviour. Direct rest and exercise CO should be measured to assess pMVR efficacy.

show abstract

MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation

Cited by 11 publications

References 17 publications

Percutaneous mitral repair: current and future devices

Percutaneous mitral repair: current and future devices

An Overview of Sport Participation and Exercise Prescription in Mitral Valve Disease

Rest and exercise oxygen uptake and cardiac output changes 6 months after successful transcatheter mitral valve repair

Contact Info

Product

Resources

About