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.
■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。