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Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial

AIMS: Functional mitral regurgitation (FMR) contributes to morbidity and mortality in heart failure (HF) patients. The aim of this study was to determine whether percutaneous mitral annuloplasty could safely and effectively reduce FMR and yield durable long-term clinical benefit. METHODS AND RESULTS...

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Autores principales: Siminiak, Tomasz, Wu, Justina C., Haude, Michael, Hoppe, Uta C., Sadowski, Jerzy, Lipiecki, Janusz, Fajadet, Jean, Shah, Amil M., Feldman, Ted, Kaye, David M., Goldberg, Steven L., Levy, Wayne C., Solomon, Scott D., Reuter, David G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403476/
https://www.ncbi.nlm.nih.gov/pubmed/22613584
http://dx.doi.org/10.1093/eurjhf/hfs076
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author Siminiak, Tomasz
Wu, Justina C.
Haude, Michael
Hoppe, Uta C.
Sadowski, Jerzy
Lipiecki, Janusz
Fajadet, Jean
Shah, Amil M.
Feldman, Ted
Kaye, David M.
Goldberg, Steven L.
Levy, Wayne C.
Solomon, Scott D.
Reuter, David G.
author_facet Siminiak, Tomasz
Wu, Justina C.
Haude, Michael
Hoppe, Uta C.
Sadowski, Jerzy
Lipiecki, Janusz
Fajadet, Jean
Shah, Amil M.
Feldman, Ted
Kaye, David M.
Goldberg, Steven L.
Levy, Wayne C.
Solomon, Scott D.
Reuter, David G.
author_sort Siminiak, Tomasz
collection PubMed
description AIMS: Functional mitral regurgitation (FMR) contributes to morbidity and mortality in heart failure (HF) patients. The aim of this study was to determine whether percutaneous mitral annuloplasty could safely and effectively reduce FMR and yield durable long-term clinical benefit. METHODS AND RESULTS: The impact of mitral annuloplasty (Carillon Mitral Contour System) was evaluated in HF patients with at least moderate FMR. Patients in whom the device was placed then acutely recaptured for clinical reasons served as a comparator group. Quantitative measures of FMR, left ventricular (LV) dimensions, New York Heart Association (NYHA) class, 6 min walk distance (6MWD), and quality of life were assessed in both groups up to 12 months. Safety and key functional data were assessed in the implanted cohort up to 24 months. Thirty-six patients received a permanent implant; 17 had the device recaptured. The 30-day major adverse event rate was 1.9%. In contrast to the comparison group, the implanted cohort demonstrated significant reductions in FMR as represented by regurgitant volume [baseline 34.5 ±11.5 mL to 17.4 ±12.4 mL at 12 months (P < 0.001)]. There was a corresponding reduction in LV diastolic volume [baseline 208.5 ±62.0 mL to 178.9 ±48.0 mL at 12 months (P =0.015)] and systolic volume [baseline 151.8 ±57.1 mL to 120.7 ±43.2 mL at 12 months (P =0.015)], compared with progressive LV dilation in the comparator. The 6MWD markedly improved for the implanted patients by 102.5 ±164 m at 12 months (P =0.014) and 131.9 ±80 m at 24 months (P < 0.001). CONCLUSION: Percutaneous reduction of FMR using a coronary sinus approach is associated with reverse LV remodelling. Significant clinical improvements persisted up to 24 months.
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spelling pubmed-34034762012-07-24 Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial Siminiak, Tomasz Wu, Justina C. Haude, Michael Hoppe, Uta C. Sadowski, Jerzy Lipiecki, Janusz Fajadet, Jean Shah, Amil M. Feldman, Ted Kaye, David M. Goldberg, Steven L. Levy, Wayne C. Solomon, Scott D. Reuter, David G. Eur J Heart Fail Treatment AIMS: Functional mitral regurgitation (FMR) contributes to morbidity and mortality in heart failure (HF) patients. The aim of this study was to determine whether percutaneous mitral annuloplasty could safely and effectively reduce FMR and yield durable long-term clinical benefit. METHODS AND RESULTS: The impact of mitral annuloplasty (Carillon Mitral Contour System) was evaluated in HF patients with at least moderate FMR. Patients in whom the device was placed then acutely recaptured for clinical reasons served as a comparator group. Quantitative measures of FMR, left ventricular (LV) dimensions, New York Heart Association (NYHA) class, 6 min walk distance (6MWD), and quality of life were assessed in both groups up to 12 months. Safety and key functional data were assessed in the implanted cohort up to 24 months. Thirty-six patients received a permanent implant; 17 had the device recaptured. The 30-day major adverse event rate was 1.9%. In contrast to the comparison group, the implanted cohort demonstrated significant reductions in FMR as represented by regurgitant volume [baseline 34.5 ±11.5 mL to 17.4 ±12.4 mL at 12 months (P < 0.001)]. There was a corresponding reduction in LV diastolic volume [baseline 208.5 ±62.0 mL to 178.9 ±48.0 mL at 12 months (P =0.015)] and systolic volume [baseline 151.8 ±57.1 mL to 120.7 ±43.2 mL at 12 months (P =0.015)], compared with progressive LV dilation in the comparator. The 6MWD markedly improved for the implanted patients by 102.5 ±164 m at 12 months (P =0.014) and 131.9 ±80 m at 24 months (P < 0.001). CONCLUSION: Percutaneous reduction of FMR using a coronary sinus approach is associated with reverse LV remodelling. Significant clinical improvements persisted up to 24 months. Oxford University Press 2012-08 2012-05-21 /pmc/articles/PMC3403476/ /pubmed/22613584 http://dx.doi.org/10.1093/eurjhf/hfs076 Text en Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2012. http://creativecommons.org/licenses/by-nc/2.0/uk/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Treatment
Siminiak, Tomasz
Wu, Justina C.
Haude, Michael
Hoppe, Uta C.
Sadowski, Jerzy
Lipiecki, Janusz
Fajadet, Jean
Shah, Amil M.
Feldman, Ted
Kaye, David M.
Goldberg, Steven L.
Levy, Wayne C.
Solomon, Scott D.
Reuter, David G.
Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial
title Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial
title_full Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial
title_fullStr Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial
title_full_unstemmed Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial
title_short Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial
title_sort treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the titan trial
topic Treatment
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403476/
https://www.ncbi.nlm.nih.gov/pubmed/22613584
http://dx.doi.org/10.1093/eurjhf/hfs076
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