Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation
Jean-François Obadia,David Messika-Zeitoun,Guillaume Leurent,Bernard Iung,Guillaume Bonnet,Nicolas Piriou,Thierry Lefèvre,Christophe Piot,Frédéric Rouleau,Didier Carrié,Mohammed Nejjari,Patrick Ohlmann,Florence Leclercq,Christophe Saint Etienne,Emmanuel Teiger,Lionel Leroux,Nicole Karam,Nicolas Michel,Martine Gilard,Erwan Donal,Jean-Noël Trochu,B. Cormier,Xavier Armoiry,Florent Boutitie,Delphine Maucort-Boulch,Cécile Barnel,Géraldine Samson,Patrice Guerin,Alec Vahanian,Nathan Mewton +29 more
TLDR
Among patients with severe secondary mitral regurgitation, the rate of death or unplanned hospitalization for heart failure at 1 year did not differ significantly between patients who underwent percutaneous mitral‐valve repair in addition to receiving medical therapy and those who received medical therapy alone.Abstract:
Background In patients who have chronic heart failure with reduced left ventricular ejection fraction, severe secondary mitral-valve regurgitation is associated with a poor prognosis. Whether percutaneous mitral-valve repair improves clinical outcomes in this patient population is unknown. Methods We randomly assigned patients who had severe secondary mitral regurgitation (defined as an effective regurgitant orifice area of >20 mm2 or a regurgitant volume of >30 ml per beat), a left ventricular ejection fraction between 15 and 40%, and symptomatic heart failure, in a 1:1 ratio, to undergo percutaneous mitral-valve repair in addition to receiving medical therapy (intervention group; 152 patients) or to receive medical therapy alone (control group; 152 patients). The primary efficacy outcome was a composite of death from any cause or unplanned hospitalization for heart failure at 12 months. Results At 12 months, the rate of the primary outcome was 54.6% (83 of 152 patients) in the intervention grou...read more
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TL;DR: LCZ696 was superior to enalapril in reducing the risks of death and of hospitalization for heart failure and decreased the symptoms and physical limitations of heart failure.
Journal ArticleDOI
Guidelines on the management of valvular heart disease The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Alec Vahanian,Helmut Baumgartner,Jeroen J. Bax,Butchart Eg,Robert Dion,Gerasimos Filippatos,Frank A. Flachskampf,Roger Hall,Bernard Iung,Jarosław D. Kasprzak,Patrick Nataf,Pilar Tornos,Lucia Torracca,Arnold Wenink,Silvia G. Priori,Jean-Jacques Blanc,Andrzej Budaj,John Camm,Veronica Dean,Jaap W. Deckers,Kenneth Dickstein,John Lekakis,Keith McGregor,Marco Metra,João Morais,Ady Osterspey,Juan Tamargo,José Luis Zamorano,Annalisa Angelini,Manuel J. Antunes,Miguel Ángel García Fernández,Christa Gohlke-Baerwolf,Gilbert Habib,John J.V. McMurray,Catherine M Otto,Luc Pierard,José L. Pomar,Bernard Prendergast,Raphael Rosenhek,Miguel Sousa Uva +39 more
TL;DR: Guidelines and Expert Consensus Documents aim to present management recommendations based on all of the relevant evidence on a particular subject in order to help physicians select the best possible management strategies for the individual patient suffering from a specific condition, taking into account the impact on outcome and also the risk–benefit ratio of a particular diagnostic or therapeutic procedure.
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