PDF(Pubmed)
Abstract：
UNASSIGNED: Hemodynamic impact of residual mitral regurgitation (MR) after transcatheter edge-to-edge repair (TEER) is not always univocally measured by transesophageal echocardiographic (TEE) assessment alone. When analyzing TEER procedure result, operators often encounter discrepancy between TEE guidance and invasive hemodynamic monitoring.
UNASSIGNED: This study sought to investigate the role of invasive hemodynamic monitoring during mitral valve TEER procedure on top of TEE guidance.
UNASSIGNED: We analyzed 78 patients with moderate-to-severe or severe MR who underwent TEER. Mitral pulse pressure fraction (MPF) was extracted from intraprocedural continuous left atrial pressure monitoring. Twenty-three patients with the same grade of MR not undergoing TEER were included as a control group. At follow-up, clinical and functional status in the majority of patients undergoing TEER were reassessed by NYHA classification and the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ).
UNASSIGNED: TEER significantly reduced MR burden on both TEE guidance and invasive hemodynamic monitoring. Post-TEER MPF was significantly reduced compared to both pre-TEER setting (P < 0.001) and control group (P < 0.001). At follow-up, while MR reduction assessed by TEE was associated with an improved functional status in terms of the 12-item KCCQ but not of NYHA classification, a greater reduction in MPF was associated with a significant amelioration of both NYHA classification (P = 0.036) and 12-item KCCQ (P = 0.032).
UNASSIGNED: MPF could provide an immediate estimate of the real hemodynamic impact of MR and a prompt prediction of the functional improvement after TEER.
UNASSIGNED: This study sought to investigate the role of invasive hemodynamic monitoring during mitral valve TEER procedure on top of TEE guidance.
UNASSIGNED: We analyzed 78 patients with moderate-to-severe or severe MR who underwent TEER. Mitral pulse pressure fraction (MPF) was extracted from intraprocedural continuous left atrial pressure monitoring. Twenty-three patients with the same grade of MR not undergoing TEER were included as a control group. At follow-up, clinical and functional status in the majority of patients undergoing TEER were reassessed by NYHA classification and the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ).
UNASSIGNED: TEER significantly reduced MR burden on both TEE guidance and invasive hemodynamic monitoring. Post-TEER MPF was significantly reduced compared to both pre-TEER setting (P < 0.001) and control group (P < 0.001). At follow-up, while MR reduction assessed by TEE was associated with an improved functional status in terms of the 12-item KCCQ but not of NYHA classification, a greater reduction in MPF was associated with a significant amelioration of both NYHA classification (P = 0.036) and 12-item KCCQ (P = 0.032).
UNASSIGNED: MPF could provide an immediate estimate of the real hemodynamic impact of MR and a prompt prediction of the functional improvement after TEER.
摘要：
■经导管边缘到边缘修复术(TEER)后残余二尖瓣反流(MR)的血流动力学影响并不总是通过单独的经食管超声心动图(TEE)评估来明确测量。分析TEER程序结果时，操作人员经常遇到TEE指导和侵入性血流动力学监测之间的差异。
■本研究旨在在TEE指导下探讨二尖瓣TEER手术期间侵入性血流动力学监测的作用。
■我们分析了78例接受TEER的中度至重度或重度MR患者。从术中连续左心房压力监测中提取二尖瓣脉压分数（MPF）。将23例未接受TEER的相同MR等级的患者作为对照组。在后续行动中,通过NYHA分类和12项堪萨斯城心肌病问卷(KCCQ)重新评估了大多数接受TEER的患者的临床和功能状态.
■TEER显著降低了TEE指导和侵入性血流动力学监测的MR负担。与TEER前设置（P<0.001）和对照组（P<0.001）相比，TEER后MPF显着降低。在后续行动中,虽然TEE评估的MR减少与12项KCCQ的功能状态改善相关，但与NYHA分类无关，MPF降低幅度越大,NYHA分级(P=0.036)和12项KCCQ(P=0.032)均显著改善.
■MPF可以立即评估MR的真实血液动力学影响，并迅速预测TEER后的功能改善。
■本研究旨在在TEE指导下探讨二尖瓣TEER手术期间侵入性血流动力学监测的作用。
■我们分析了78例接受TEER的中度至重度或重度MR患者。从术中连续左心房压力监测中提取二尖瓣脉压分数（MPF）。将23例未接受TEER的相同MR等级的患者作为对照组。在后续行动中,通过NYHA分类和12项堪萨斯城心肌病问卷(KCCQ)重新评估了大多数接受TEER的患者的临床和功能状态.
■TEER显著降低了TEE指导和侵入性血流动力学监测的MR负担。与TEER前设置（P<0.001）和对照组（P<0.001）相比，TEER后MPF显着降低。在后续行动中,虽然TEE评估的MR减少与12项KCCQ的功能状态改善相关，但与NYHA分类无关，MPF降低幅度越大,NYHA分级(P=0.036)和12项KCCQ(P=0.032)均显著改善.
■MPF可以立即评估MR的真实血液动力学影响，并迅速预测TEER后的功能改善。
