Mitral valve repair via catheter offers better outcomes than pharmacological treatment in patients with heart failure
- The main novelty of this study is the significant benefit observed even in patients with moderate mitral regurgitation
- The study has been published in the New England Journal of Medicine, and Professor Antoni Bayés-Genís from the Germans Trias Hospital was part of the management team
One-third of patients with heart failure suffer from a problem with the mitral valve in the heart: it doesn't close properly, a condition known as mitral regurgitation. As a result, people with this condition feel weak, fatigued, or have difficulty breathing and performing daily activities such as walking, climbing stairs, or carrying groceries.
A study recently published in the New England Journal of Medicine, and presented at the European Society of Cardiology Congress held from 30 August to 2 September, has demonstrated the benefits of placing a clip on the valve instead of the usual medical treatment.
This study, in which Professor Antoni Bayés-Genís from Germans Trias Hospital was part of the management team, shows that this significant benefit also applies to patients with moderate mitral regurgitation. This finding allows for faster treatment and improves the patient's clinical condition before it becomes too late. The catheter-based treatment involves placing a clip on the mitral valve without the need for surgery, through a minimally invasive procedure that only requires a 2-3 day hospital stay, enabling patients to quickly return to their normal lives.
The study involved 505 patients from 30 centres in nine countries, divided into two groups: one group received mitral valve repair along with the recommended medical treatment, while the other group received only the usual medical treatment. After 24 months, the group that received the valve repair showed a significant reduction in the rate of recurrent hospitalisations for heart failure or cardiovascular death, compared to the group that only received medical treatment. Additionally, patients who underwent valve repair experienced a notable improvement in their quality of life after 12 months, as measured by the Kansas City Cardiomyopathy Questionnaire.
This is an international study, and Professor Bayés-Genís, principal investigator of the ICREC (Heart Failure and Cardiac Regeneration) research group at the Germans Trias i Pujol Research Institute (IGTP), explains that this could represent a turning point in the treatment of many patients with mitral valve insufficiency. "We now have new evidence showing that a minimally invasive procedure is beneficial even in less severe patients, and this should revolutionise clinical guidelines," says Bayés, adding that the goal "should always be to improve these patients' quality of life and prevent them from needing hospitalisation, and this study proves that."
Reference
Anker SD, Friede T, von Bardeleben RS, Butler J, Khan MS, Diek M, Heinrich J, Geyer M, Placzek M, Ferrari R, Abraham WT, Alfieri O, Auricchio A, Bayes-Genis A, Cleland JGF, Filippatos G, Gustafsson F, Haverkamp W, Kelm M, Kuck KH, Landmesser U, Maggioni AP, Metra M, Ninios V, Petrie MC, Rassaf T, Ruschitzka F, Schäfer U, Schulze PC, Spargias K, Vahanian A, Zamorano JL, Zeiher A, Karakas M, Koehler F, Lainscak M, Öner A, Mezilis N, Theofilogiannakos EK, Ninios I, Chrissoheris M, Kourkoveli P, Papadopoulos K, Smolka G, Wojakowski W, Reczuch K, Pinto FJ, Wiewiórka Ł, Kalarus Z, Adamo M, Santiago-Vacas E, Ruf TF, Gross M, Tongers J, Hasenfuss G, Schillinger W, Ponikowski P; RESHAPE-HF2 Investigators. Transcatheter Valve Repair in Heart Failure with Moderate to Severe Mitral Regurgitation. N Engl J Med. 2024 Aug 31. DOI: 10.1056/NEJMoa2314328.