Influence of percutaneous transcatheter correction of mitral regurgitation on chronic heart failure
Objective. To analyze the effect of transcatheter correction of mitral regurgitation on the course of chronic heart failure (CHF). Materials and methods. The study enrolled 43 patients who were treated at the Chazov National Medical Research Center for Cardiology. All patients had CHF NYHA class II-IV and severe mitral regurgitation. Patients underwent transcatheter mitral valve repair. All patients underwent the following examinations before implantation of device and 6 months later (12-lead ECG, transthoracic echocardiography), 6-minute walk test, serum NT-proBNP). Results. Median age of patients was 72.5 [65.8; 83.0] years old, 58.1% were men. All surgeries were successful. Four (9.3%) patients died (in-hospital period - 1 patient, delayed period - 2 patients). After six months, we observed decrease of CHF NYHA class from 2.79±0.6 to 1.89±0.8 (p<0.001), improvement of 6-minute walk from 259.4±105.4 to 370.7±108.6 m (p=0.02), decrease in the need for furosemide from 40.00 [20.00; 80.00] to 20.00 [10.00; 40.00] (p=0.02) and serum NT-proBNP from 1295.00 [783.20; 3506.00] to 1251.00 [435.75; 1940] pg/ml (p=0.09). The number of patients with mild-to-moderate mitral regurgitation after 6 months was revealed in 33 (86.8%) patients, severe regurgitation - in 5 (13.2%) patients. Clinical development of CHF was observed both in patients with primary and secondary mitral regurgitation. Conclusion. Patients with CHF demonstrate persistent decrease in mitral regurgitation with clinical improvement, increase of exercise tolerance and less need for diuretic therapy after transcatheter correction of mitral regurgitation.