AimThis analysis aimed to compare the clinical outcomes associated with heart failure (HF) readmissions and to identify associations with HF hospitalizations (HFH) in patients treated with the MitraClip™ NTR/XTR System in the EXPAND study.Methods and resultsThe global, real‐world EXPAND study enrolled 1041 patients with primary or secondary mitral regurgitation (MR) treated with the MitraClip NTR/XTR System. Echocardiograms were analysed by an independent echocardiographic core laboratory. The study population was stratified into HFH and No‐HFH groups based on the occurrence of HFH 1 year post‐index procedure. Clinical outcomes including MR severity, New York Heart Association (NYHA) functional class, Kansas City Cardiomyopathy Questionnaire (KCCQ) score, and all‐cause mortality were compared (HFH: n = 181; No‐HFH: n = 860). Both groups achieved consistent 1‐year MR reduction to ≤1+ (HFH vs. No‐HFH: 87.3% vs. 89.5%, p = 0.6) and significant 1‐year improvement in KCCQ scores (+16.5 vs. +22.3, p = 0.09) and NYHA functional class. However, more patients in the No‐HFH group had 1‐year NYHA class ≤II (HFH vs. No‐HFH: 67.9% vs. 81.9%, p < 0.01). All‐cause mortality at 1 year was 36.8% in the HFH group versus 10.4% in the No‐HFH group (p < 0.001). The HFH rate decreased by 63% at 1 year post‐M‐TEER versus 1 year pre‐treatment (relative risk 0.4, p < 0.001). Independent HFH associations were MR ≥2+ at discharge, HFH 1 year prior to treatment, baseline NYHA class ≥III, baseline tricuspid regurgitation ≥2+, and baseline left ventricular ejection fraction ≤40%.ConclusionsThis study reports the impact of HFH on clinical outcomes post‐treatment in the EXPAND study. Results demonstrate that the occurrence of HFH was associated with worse 1‐year survival, and treatment with the MitraClip system substantially reduced HFH and improved patient symptoms and quality of life.

中文翻译：

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心力衰竭住院对二尖瓣经导管边对边修复后临床结果的影响：EXPAND 研究结果


目的本分析旨在比较 EXPAND 研究中使用 MitraClip™ NTR/XTR 系统治疗的患者与心力衰竭 (HF) 再入院相关的临床结果，并确定与心力衰竭住院 (HFH) 的关联。方法和结果全球真实世界EXPAND 研究招募了 1041 名原发性或继发性二尖瓣反流 (MR) 患者，并接受 MitraClip NTR/XTR 系统治疗。超声心动图由独立的超声心动图核心实验室进行分析。根据索引手术后 1 年 HFH 的发生情况，将研究人群分为 HFH 组和无 HFH 组。比较了临床结果，包括 MR 严重程度、纽约心脏协会 (NYHA) 功能分级、堪萨斯城心肌病问卷 (KCCQ) 评分和全因死亡率（HFH：n = 181；无 HFH：n = 860）。两组的 1 年 MR 一致降低至 ≤1+（HFH 与无 HFH：87.3% vs. 89.5%，p = 0.6），并且 KCCQ 评分显着改善 1 年（+16.5 vs. +22.3，p = 0.09) 和 NYHA 功能等级。然而，No-HFH 组中更多患者的 1 年 NYHA 分级≤II（HFH 与 No-HFH：67.9% vs. 81.9%，p < 0.01）。 HFH 组 1 年全因死亡率为 36.8%，而无 HFH 组为 10.4%（p < 0.001）。与治疗前 1 年相比，M-TEER 治疗后 1 年 HFH 发生率下降 63%（相对风险 0.4，p < 0.001）。独立的 HFH 关联为出院时 MR ≥2+、治疗前 1 年 HFH、基线 NYHA 分级 ≥ III、基线三尖瓣反流 ≥ 2+、基线左心室射血分数 ≤ 40%。 结论 本研究报告了 HFH 对临床的影响EXPAND 研究中治疗后的结果。 结果表明，HFH 的发生与较差的 1 年生存率相关，而 MitraClip 系统的治疗可显着减少 HFH，并改善患者症状和生活质量。