Cardiovascular medicine heart failure (CVM-HF) index as prognostic model for candidates to MitraClip therapy

Abstract

Transcatheter MitraClip repair is a new tool for the management of severe mitral regurgitation in patients at very high risk for conventional surgery. Aim of our study was reporting one-year clinical outcomes in candidates to MitraClip procedures, divided into three groups according to the cardiovascular medicine heart failure (CVM-HF) index. The study population consists of 46 consecutive patients, divided, in accordance with CVM-HF index, as follows: one patient in the low-risk category (group A); 27 patients in the medium-risk (group B) and 18 patients in high-risk category (group C). The primary study endpoint was a combined of all-cause mortality and re-hospitalization rate. Secondary endpoints were all-cause mortality and cardiac mortality. Patients of group B and group C were compared. Regarding the primary endpoint, patients in group C had significantly poorer outcomes than patients in group B, with a 12-month survival freedom from events of 44.4 and 74.1 %, respectively (log-rank test, p = 0.039); survival freedom from cardiac mortality was 100 and 83.3 % in group B and C, respectively (log-rank test, p = 0.027). One-year survival free from re-hospitalization was 74.1 % in group B and 39.9 % in group C (log-rank test; p = 0.036). Survival free from all-cause of mortality was 92.6 and 77.8 %, respectively (log-rank test; p = 0.129). In our initial experience the CVM-HF index showed to be valuable for understanding if the patient with advanced heart failure and functional mitral regurgitation can really benefit by MitraClip therapy.

Keywords: Heart failure; MitraClip; Mitral regurgitation; Prognosis.