Researchers in Germany have found that a popular risk score for patients with degenerative mitral regurgitation (MR) can be used to predict the outcomes of patients undergoing transcatheter edge-to-edge repair (TEER). The team shared its findings in the Journal of the American Heart Association.
The analysis included 680 high-risk patients who underwent TEER, the procedure known for years as transcatheter mitral valve repair, at one of three German facilities from August 2010 to September 2018. All procedures were performed using Abbott’s MitraClip device.
Seven different parameters—age, heart failure symptoms, atrial fibrillation, left atrial diameter, right ventricular systolic pressure, left ventricular end-systolic diameter and left ventricular ejection fraction—were used to develop each patient’s Mitral Regurgitation International Database (MIDA) mortality score. If any of these factors were unknown, the patient was not included in this analysis. For more than 400 patients, mitral regurgitation (MR) was assessed using echocardiograms during follow-up visits.
The highest possible MIDA score was a 12. Overall, after two years, the mortality rates were 8.2% for patients with low MIDA scores, 21.3% for patients with intermediate MIDA scores and 26.3% for patients with high MIDA scores. Every additional point of the MIDA score was associated with a 13% higher risk of all-cause mortality. The risk of being hospitalized for heart failure was also found to be more common as a patient’s MIDA score increased.
In addition, the team found, the MIDA score was equally effective for assessing patients with functional MR.
“The MIDA score may be helpful in the risk stratification process, evaluating MitraClip implantation in patients with heart failure with significant MR, and identifying those who are in need of a more intense monitoring, with an increased hazard of reduced procedural success, sustainability, and worse postprocedural prognosis,” wrote lead author Refik Kavsur, MD, University Hospital Bonn in Germany, and colleagues.