Abstract:
OBJECTIVES:The purpose of this study was to characterize patients with mitral regurgitation (MR) and atrial fibrillation (AF) treated percutaneously using the MitraClip device (Abbott Vascular, Abbott Park, Illinois) and compare the results with surgery in this population. BACKGROUND:The EVEREST II (Endovascular Valve Edge-to-Edge Repair Study) randomized controlled trial compared a less invasive catheter-based treatment for MR with surgery, providing an opportunity to assess the impact of AF on the outcomes of both the MitraClip procedure and surgical repair. METHODS:The study population included 264 patients with moderately severe or severe MR assessed by an independent echocardiographic core laboratory. Comparison of safety and effectiveness study endpoints at 30 days and 1 year were made using both intention-to-treat and per-protocol (cohort of patients with MR ≤2+ at discharge) analyses. RESULTS:Pre-existing AF was present in 27% of patients. These patients were older, had more advanced disease, and were more likely to have a functional etiology. Similar reduction of MR to ≤2+ before discharge was achieved in patients with AF (83%) and in patients without AF (75%, p = 0.3). Freedom from death, mitral valve surgery for valve dysfunction, and MR >2+ was similar at 12 months for AF patients (64%) and for no-AF patients (61%, p = 0.3). At 12 months, MR reduction to <2+ was greater with surgery than with MitraClip, but there was no interaction between rhythm and MR reduction, and no difference in all-cause mortality between patients with and patients without AF. CONCLUSIONS:Atrial fibrillation is associated with more advanced valvular disease and noncardiac comorbidities. However, acute procedural success, safety, and 1-year efficacy with MitraClip therapy is similar for patients with AF and without AF.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Herrmann HC,Gertz ZM,Silvestry FE,Wiegers SE,Woo YJ,Hermiller J,Segar D,Heimansohn D,Gray W,Homma S,Argenziano M,Wang A,Jollis J,Lampert MB,Alexander J,Mauri L,Foster E,Glower D,Feldman Tdoi
10.1016/j.jacc.2011.12.023subject
Has Abstractpub_date
2012-04-03 00:00:00pages
1312-9issue
14eissn
0735-1097issn
1558-3597pii
S0735-1097(12)00245-8journal_volume
59pub_type
杂志文章,多中心研究,随机对照试验abstract:OBJECTIVES:We tested the hypothesis that cardioprotection with ischemic preconditioning (PC) is lost in the aging, or senescent, heart. BACKGROUND:Although infarct size reduction with PC has been documented in virtually all models, a purported exception to this paradigm is the aging heart, the population in which card...
journal_title:Journal of the American College of Cardiology
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abstract::To evaluate the variability in the reported accuracy of the exercise electrocardiogram (ECG) for predicting severe coronary disease, meta analysis was applied to 60 consecutively published reports comparing exercise-induced ST depression with coronary angiographic findings. The 60 reports included 62 distinct study gr...
journal_title:Journal of the American College of Cardiology
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abstract:BACKGROUND:Reliable methods for predicting myocardial infarction in patients with established coronary artery disease are lacking. Coronary 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) provides an assessment of atherosclerosis activity. OBJECTIVES:This study assessed whether 18F-NaF PET predicts my...
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更新日期:2013-03-05 00:00:00
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更新日期:2012-05-01 00:00:00
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更新日期:2017-08-22 00:00:00
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更新日期:2004-01-21 00:00:00
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