Diastology and MitraClip® Outcomes: Multicenter Real-World Evidence Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
- The symptom-improvement group (Group 1): patients who had a change in their baseline KCCQ (Kansas City Cardiomyopathy Questionnaire) score > 20 at one year, an absence of heart failure hospitalization/death, and a <50% increase in their preprocedural diuretic usage.
- The stable-symptom group (Group 2): patients with no heart failure hospitalization or death in the one-year follow-up period, but with a change in their baseline KCCQ score < 20 or increase in their diuretic usage > 50%.
- The symptom-worsening group (Group 3): patients who experienced heart failure-related hospitalizations or death in the one-year follow-up period.
2.2. Methodology and Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Symptom-Improvement Group (94) | Symptom-Stable Group (45) | Symptom-Worsening/Death Group (85) | |
---|---|---|---|
Mean Age (Years) | 71.53 (68.98–74.07) | 74.24 (70.42–78.06) | 70.01 (67.15–72.86) |
Sex | Male: 54 (57.44%) | Male: 21 (46.66%) | Male: 63 (74.11%) |
Female: 40 (42.55%) | Female: 24 (53.33%) | Female: 22 (25.88%) | |
Race | White: 63 (67.02%) | White: 34 (75.56%) | White: 39 (45.88%) |
Black: 31 (32.98%) | Black: 9 (20.00%) | Black: 43 (50.59%) | |
Participation in Cardiac Rehabilitation (%) | 33 (37.50%) | 9 (22.50%) | 6 (7.50%) |
History of Atrial Fibrillation (%) | 62 (68.89%) | 30 (69.77%) | 60 (74.07%) |
COPD Prevalence (%) | 34 (37.78%) | 22 (51.16%) | 34 (43.04%) |
CKD Prevalence (%) | 52 (55.32%) | 20 (44.44%) | 57 (67.06%) |
History of Myocardial Infarction (%) | 36 (40.00%) | 22 (53.66%) | 23 (29.11%) |
Adherence to ACE/ARB/Entresto (%) | 64 (71.11%) | 17 (40.48%) | 50 (61.73%) |
Adherence to Beta Blocker Therapy (%) | 71 (78.89%) | 41 (95.35%) | 74 (92.50%) |
Cardiac Resynchronization Therapy Post Procedure (%) | 38 (42.22%) | 16 (38.10%) | 31 (38.75%) |
Pre-Procedural ECHO Parameters | Group | Mean | SD | 95% CI for Mean | p Value | |
---|---|---|---|---|---|---|
Lower Bound | Upper Bound | |||||
Left Atrial Volume Index (mL/m2) | Symptom improvement | 62.200 | 26.7069 | 54.765 | 69.635 | 0.15 |
Symptom-stable | 53.016 | 24.1662 | 44.715 | 61.318 | ||
Symptom-worsening/death | 60.792 | 35.9249 | 51.512 | 70.073 | ||
E/A Ratio | Symptom improvement | 1.909 | 0.9194 | 1.681 | 2.137 | 0.02 |
Symptom-stable | 1.729 | 0.8088 | 1.460 | 1.999 | ||
Symptom-worsening/death | 2.360 | 1.5389 | 1.975 | 2.744 | ||
MV Deceleration Time\ (ms) | Symptom improvement | 201.54 | 67.944 | 186.01 | 217.07 | 0.03 |
Symptom-stable | 212.50 | 80.833 | 186.65 | 238.35 | ||
Symptom-worsening/death | 176.88 | 52.232 | 164.14 | 189.62 | ||
MV Gradient (mm Hg) | Symptom improvement | 1.90 | 1.012 | 1.69 | 2.11 | <0.01 |
Symptom-stable | 2.77 | 2.125 | 2.11 | 3.42 | ||
Symptom-worsening/death | 1.90 | 0.799 | 1.72 | 2.08 |
Pre-Procedural Echocardiographic Parameters | Odds Ratio of Association with Symptom-Worsening Group | 95% Confidence Interval | p-Value |
---|---|---|---|
E/A Ratio | 1.51 | 1.10–2.06 | 0.010 |
MV Deceleration time (ms) | 0.99 | 0.98–0.99 | 0.008 |
MV Gradient (mm Hg) | 0.822 | 0.63–1.07 | 0.148 |
Left Atrial Volume Index (mL/m2) | 1.003 | 0.99–1.01 | 0.583 |
Pre-Procedural Echocardiographic Parameters | Odds Ratio of Association with Symptom-Worsening Group | 95% Confidence Interval | p-Value |
---|---|---|---|
E/A ratio | 1.61 | 1.13–2.29 | 0.008 |
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Joseph Varughese, V.; Richardson, C.; Pollock, J.; Czyzewski, P.; Mujadzic, H.; Cryer, M. Diastology and MitraClip® Outcomes: Multicenter Real-World Evidence Study. Medicina 2025, 61, 1092. https://doi.org/10.3390/medicina61061092
Joseph Varughese V, Richardson C, Pollock J, Czyzewski P, Mujadzic H, Cryer M. Diastology and MitraClip® Outcomes: Multicenter Real-World Evidence Study. Medicina. 2025; 61(6):1092. https://doi.org/10.3390/medicina61061092
Chicago/Turabian StyleJoseph Varughese, Vivek, Chandler Richardson, James Pollock, Patryk Czyzewski, Hata Mujadzic, and Michael Cryer. 2025. "Diastology and MitraClip® Outcomes: Multicenter Real-World Evidence Study" Medicina 61, no. 6: 1092. https://doi.org/10.3390/medicina61061092
APA StyleJoseph Varughese, V., Richardson, C., Pollock, J., Czyzewski, P., Mujadzic, H., & Cryer, M. (2025). Diastology and MitraClip® Outcomes: Multicenter Real-World Evidence Study. Medicina, 61(6), 1092. https://doi.org/10.3390/medicina61061092