Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years. (18th November 2019)

• Record Type: Journal Article
• Authors: Iung, Bernard; Armoiry, Xavier; Vahanian, Alec; Boutitie, Florent; Mewton, Nathan; Trochu, Jean‐Noël; Lefèvre, Thierry; Messika‐Zeitoun, David; Guerin, Patrice; Cormier, Bertrand; Brochet, Eric; Thibault, Hélène; Himbert, Dominique; Thivolet, Sophie; Leurent, Guillaume; Bonnet, Guillaume; Donal, Erwan; Piriou, Nicolas; Piot, Christophe; Habib, Gilbert; Rouleau, Frédéric; Carrié, Didier; Nejjari, Mohammed; Ohlmann, Patrick; Saint Etienne, Christophe; Leroux, Lionel; Gilard, Martine; Samson, Géraldine; Rioufol, Gilles; Maucort‐Boulch, Delphine; Obadia, Jean François;
• Other Names: Obadia Jean‐François investigator.; Barthelet Martine investigator.; Grinberg Daniel investigator.; Rioufol Gilles investigator.; Thibault Hélène investigator.; Thivolet Sophie investigator.; Furber Alain investigator.; Benard Thomas investigator.; Debrux Jean‐Louis investigator.; Pinaud Frédéric investigator.; Rouleau Frédéric investigator.; Chocron Sidney investigator.; Chopard Romain investigator.; Meneveau Nicolas investigator.; Schiele François investigator.; Gilard Martine investigator.; Boschat Jacques investigator.; Castellant Philippe investigator.; Jobic Yannick investigator.; Le Ven Florent investigator.; Romain Didier investigator.; Beygui Farzin investigator.; Sabatier Rémi investigator.; Saloux Eric investigator.; Motreff Pascal investigator.; Clerfond Guillaume investigator.; Azarnoush Kasra investigator.; Lusson Jean René investigator.; Vorilhon Charles investigator.; Teiger Emmanuel investigator.; Antoine Clémence investigator.; Champagne Stéphane investigator.; Couetil Jean‐Paul investigator.; Damy Thibault investigator.; Dubois‐Rande Jean‐Luc investigator.; Ernande Laura investigator.; Guendouz Soulef investigator.; Lim Pascal investigator.; Monin Jean‐Luc investigator.; Nguyen Annabelle investigator.; Riant Elisabeth investigator.; Ternacle Julien investigator.; Zerbib Céline investigator.; Bertrand Bernard investigator.; Bouvaist Hélène investigator.; Saunier Carole investigator.; Vaislic Claude investigator.; Khelifa Riadh Cheikh investigator.; Favereau Xavier investigator.; Hilpert Loïc investigator.; Maribas Philippe investigator.; Azmoun Alexandre investigator.; Angel Jean‐Yves investigator.; Baruteau Alban investigator.; Brenot Philippe investigator.; Deleuze Philippe investigator.; Garcon Philippe investigator.; Raoux François investigator.; Slama Michel investigator.; Van Belle Eric investigator.; Prat Alain investigator.; Coisne Augustin investigator.; Duvapentiah Anju investigator.; Juthier Francis investigator.; Modine Thomas investigator.; Polge Anne‐Sophie investigator.; Richardson Marjorie investigator.; Rousse Natacha investigator.; Spillemaeker Hugues investigator.; Sudre Arnaud investigator.; Vincent Flavien investigator.; Vincentelli André investigator.; Jeu Antoine investigator.; Ketelers Régis investigator.; Bonnet Jean‐Louis investigator.; Bonnet Guillaume investigator.; Habib Gilbert investigator.; Michel Nicolas investigator.; Pankert Mathieu investigator.; Salaun Erwan investigator.; Collart Frédéric investigator.; Houël Rémi investigator.; Bille Jacques investigator.; Commeau Philippe investigator.; Joly Patrick investigator.; Michel Nicolas investigator.; Philip Emmanuel investigator.; Collet Frédéric investigator.; Arméro Sébastien investigator.; Bayet Gilles investigator.; Giacomoni Marie‐Paule investigator.; Maximovitch Alexandre investigator.; Lefèvre Thierry investigator.; Cormier Bertrand investigator.; Romano Mauro investigator.; Leclercq Florence investigator.; Albat Bernard investigator.; Cade Stéphane investigator.; Cransac Frédéric investigator.; Macia Jean‐Christophe investigator.; Piot Christophe investigator.; Francois Fabrice investigator.; Pons Maxime investigator.; Raczka Franck investigator.; Sportouch Catherine investigator.; Juillière Yves investigator.; Folliguet Thierry investigator.; Huttin Olivier investigator.; Popovic Batric investigator.; Selton‐Suty Christine investigator.; Venner Clément investigator.; Guérin Patrice investigator.; Baron Olivier investigator.; Letocart Vincent investigator.; Letourneau Thierry investigator.; Piriou Nicolas investigator.; Trochu Jean‐Noël investigator.; Belliard Olivier investigator.; Allouch Philippe investigator.; Bensouda Christophe investigator.; Janower Sandra investigator.; Makowski Serge investigator.; Pasquier Damien investigator.; Pillière Rémy investigator.; Rosencher Julien investigator.; Moceri Pamela investigator.; Vahanian Alex investigator.; Brochet Eric investigator.; Himbert Dominique investigator.; Iung Bernard investigator.; Nataf Patrick investigator.; Spaulding Christian investigator.; Achouh Paul investigator.; Berrebi Alain investigator.; Jouan Jérôme investigator.; Karam Nicole investigator.; Mirabel Mariana investigator.; Puscas Tania investigator.; Riant Elisabeth investigator.; Suen Po Wen investigator.; Caussin Christophe investigator.; Berrebi Alain investigator.; Diakov Christelle investigator.; Philippe François investigator.; Veugeois Aurélie investigator.; Collet Jean Philippe investigator.; Choussat Rémi investigator.; Isnard Richard investigator.; Montalescot Gilles investigator.; Leroux Lionel investigator.; Coste Pierre investigator.; Dijos Marina investigator.; Labrousse Louis investigator.; Lafitte Stéphane investigator.; Picard François investigator.; Raud‐Raynier Pascale investigator.; Degrand Bruno investigator.; Bedossa Marc investigator.; Corbineau Hervé investigator.; Donal Erwan investigator.; Leurent Guillaume investigator.; Eltchaninoff Hélène investigator.; Bauer Fabrice investigator.; Tron Christophe investigator.; Nejjari Mohammed investigator.; Attias Davis investigator.; Gerbay Antoine investigator.; Pierrard Romain investigator.; Fuzellier Jean‐François investigator.; Drogoul Laurent investigator.; Elebeze Jean‐Pierre investigator.; Lopez Stéphane investigator.; Mariottini Claude investigator.; Meyer Pierre investigator.; Mihoubi Alain investigator.; Tapia Michel investigator.; Teboul Jacques investigator.; Ohlmann Patrick investigator.; Goette‐Dimarco Paola investigator.; Kretz Jean‐Georges investigator.; Mommerot Arnaud investigator.; Morel Olivier investigator.; Petit‐Eisenmann Hélène investigator.; Samet Annie investigator.; Trinh Annie investigator.; Carrié Didier investigator.; Gautier Mathieu investigator.; Badie Yoan Lavie investigator.; Lhermusier Thibault investigator.; Marcheix Bernard investigator.; Tchétché Didier investigator.; Abouliatim Issam investigator.; Bonfils Laurent investigator.; Dumonteil Nicolas investigator.; Farah Bruno investigator.; Fondard Olivier investigator.; Pathak Atul investigator.; Etienne Christophe Saint investigator.; Bernard Anne investigator.; Dion Fany investigator.; Loardi Claudia investigator.; Quilliet Laurent investigator.; Seemann Aurélien investigator.; Antoine Clémence investigator.; Arnoult Marc Antoine investigator.; Meurisse Yvon investigator.; Wautot Fabrice investigator.; Champagnac Didier investigator.; Dementhon Julie investigator.; Doisy Vincent investigator.; Frieh Jean‐Philippe investigator.; Garrier Olivier investigator.; Jamal Fadi investigator.; Lamartine Stéphanie investigator.; Leroux Pierre‐Yves investigator.; Lienhart Yves investigator.; Staat Patrick investigator.; Zouaghi Oualid investigator.;
• Is Part Of: European journal of heart failure. Volume 21:Number 12(2019)
• Page Start: 1619
• Page End: 1627
• Publication Date: 2019-11-18
• Subjects: Secondary mitral regurgitation -- Heart failure -- Percutaneous mitral valve repair; Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1002/ejhf.1616
• Languages: English
• ISSNs: 1388-9842

Abstract

Abstract: Aims: The MITRA‐FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline‐directed medical treatment alone. We report the 24‐month outcome from this trial. Methods and results: At 37 centres, we randomly assigned 304 symptomatic heart failure patients with severe secondary mitral regurgitation (effective regurgitant orifice area >20 mm 2 or regurgitant volume >30 mL), and left ventricular ejection fraction between 15% and 40% to undergo percutaneous valve repair plus medical treatment (intervention group, n = 152) or medical treatment alone (control group, n = 152). The primary efficacy outcome was the composite of all‐cause death and unplanned hospitalization for heart failure at 12 months. At 24 months, all‐cause death and unplanned hospitalization for heart failure occurred in 63.8% of patients (97/152) in the intervention group and 67.1% (102/152) in the control group [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.77–1.34]. All‐cause mortality occurred in 34.9% of patients (53/152) in the intervention group and 34.2% (52/152) in the control group (HR 1.02, 95% CI 0.70–1.50). Unplanned hospitalization for heart failure occurred in 55.9% of patients (85/152) in the intervention group and 61.8% (94/152) in the control group (HR 0.97, 95% CI 0.72–1.30). Conclusions: In patients with severe secondary mitral regurgitation, percutaneous repair added to medical treatment did not significantly reduce the risk of death or hospitalization for heart failure at 2 years compared with medical treatment alone.