期刊
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
卷 11, 期 6, 页码 464-469出版社
OXFORD UNIV PRESS
DOI: 10.1093/ehjacc/zuac053
关键词
Heart failure; Functional mitral regurgitation; Pulmonary hypertension; MitraClip; Transcatheter mitral valve repair
In patients with functional mitral regurgitation and pulmonary hypertension, pre-procedural vasodilator challenge with sodium nitroprusside may help predict haemodynamic improvement after transcatheter edge-to-edge repair.
The effectiveness of transcatheter edge-to-edge repair (TEER) in patients with functional mitral regurgitation (FMR) and pulmonary hypertension (PH) is still debated and pre-procedural predictors of haemodynamic improvement after TEER in this setting are currently unknown. We investigated whether normalization of pulmonary artery wedge pressure (PAWP) in response to sodium nitroprusside (SNP) during baseline right heart catheterization might be predictive of a favourable haemodynamic response to MitraClip in patients with FMR and PH. Among 22 patients enrolled, 13 had a positive response to SNP (responders), nine were non-responders. At 6-months follow-up, responders showed a 33% reduction in PAWP and a 25% reduction in mean pulmonary artery pressure (PAP) (P = 0.002 and 0.004, respectively); no significant change occurred in non-responders. In patients with FMR and PH, pre-procedural vasodilator challenge with SNP may help define patients who may have haemodynamic improvement after TEER.
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