Response to acute vasodilator challenge and haemodynamic modifications after MitraClip in patients with functional mitral regurgitation and pulmonary hypertension.
Alessandro Mandurino-MirizziAndrea MunafòClaudia RaineriGiulia MagriniRomina FrassicaLuca ArzuffiLaura ScelsiAnnalisa TurcoMarco FerliniFabrizio GazzoliMaurizio FerrarioStefano GhioLuigi Oltrona-ViscontiGabriele CrimiPublished in: European heart journal. Acute cardiovascular care (2022)
The effectiveness of transcatheter edge-to-edge repair (TEER) in patients with functional mitral regurgitation (FMR) and pulmonary hypertension (PH) is still debated and pre-procedural predictors of haemodynamic improvement after TEER in this setting are currently unknown. We investigated whether normalization of pulmonary artery wedge pressure (PAWP) in response to sodium nitroprusside (SNP) during baseline right heart catheterization might be predictive of a favourable haemodynamic response to MitraClip in patients with FMR and PH. Among 22 patients enrolled, 13 had a positive response to SNP (responders), nine were non-responders. At 6-months follow-up, responders showed a 33% reduction in PAWP and a 25% reduction in mean pulmonary artery pressure (PAP) (P = 0.002 and 0.004, respectively); no significant change occurred in non-responders. In patients with FMR and PH, pre-procedural vasodilator challenge with SNP may help define patients who may have haemodynamic improvement after TEER.
Keyphrases
- pulmonary artery
- pulmonary hypertension
- pulmonary arterial hypertension
- genome wide
- coronary artery
- mitral valve
- high density
- randomized controlled trial
- liver failure
- heart failure
- systematic review
- dna methylation
- genetic diversity
- atrial fibrillation
- intensive care unit
- gene expression
- hepatitis b virus
- aortic dissection
- extracorporeal membrane oxygenation