Pulmonary artery pressures and outcomes after MitraClip

Abstract

Abstract Aims We evaluated the impact of MitraClip on systolic pulmonary artery pressure (sPAP) and the effects of baseline sPAP on outcomes. Methods and results In a cohort of patients who underwent MitraClip implantation, three groups were defined according to pre‐procedure sPAP levels. Clinical and echocardiographic data were compared. The study included 177 patients: 59 had severe pulmonary hypertension (PHT), 96 had mild to moderate PHT, and 22 had no PHT. In patients with pre‐existing severe PHT, sPAP was reduced from 70.8 ± 9.2 to 56.8 ± 13.7 mmHg (P < 0.001), sPAP remained unchanged in patients with mild to moderate PHT but was significantly increased from 30.8 ± 4.3 to 38.6 ± 8.3 mmHg in the no‐PHT group (P < 0.001). Improvement of sPAP was observed in 77% of severe PHT group, while worsening of sPAP was more common among patients with no‐PHT [57% compared with 33% among the mild to moderate PHT and 7% in the severe PHT group, respectively, (P < 0.001)]. One year survival was similar among the study groups. Conclusions MitraClip decreases PHT among patients with severe PHT. A concerning finding is that most patients with no‐PHT increase their sPAP.

Keywords

• Mitral regurgitation
• Transcatheter mitral valve repair
• MitraClip
• Pulmonary hypertension
• Heart failure