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A Meta-Analysis of Quality of Life Outcomes After Transcatheter Edge-to-Edge Mitral Valve Repair in Secondary Mitral Regurgitation
Session:
SESSÃO DE POSTERS 20 - IC E INTERVENÇÃO VALVULAR
Speaker:
Barbara Lage Garcia
Congress:
CPC 2025
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Bárbara Lage Garcia; Emídio Mata; Margarida Castro; Luísa Pinheiro; Mariana Tinoco; João Português; Francisco Ferreira; Sílvia Ribeiro; Lucy Calvo; António Lourenço
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Background</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Secondary mitral regurgitation (SMR) often complicates heart failure (HF), worsening quality of life (QoL) outcomes. Transcatheter edge-to-edge mitral valve repair (MTEER) offers a minimally invasive alternative to address SMR. This meta-analysis evaluated the impact of MTEER on QoL in SMR patients compared to guideline-directed medical therapy (GDMT).</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Methods</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">On September, 2024, PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science were searched for randomized controlled trials (RCTs) of patients with HF and SMR, randomized to receive either MTEER with GDMT or GDMT alone assessing QoL outcomes. Pooled data were analyzed using an inverse variance random-effects model, calculating standardized mean differences (SMD) for changes from baseline to compare different QoL questionnaires.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Results</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">From 1558 identified articles, the final analysis included three trials: COAPT, MITRA-FR, and RESHAPE-HF2, totaling 1423 patients. Both COAPT and RESHAPE-HF2 measured QoL using the Kansas City Cardiomyopathy Questionnaire and reported changes from baseline at 12 months. COAPT demonstrated significant QoL improvements in the MTEER group (MD 15.4 CI 9.92; 20.88), with benefits persisting for up to 5 years, a similar finding observed in RESHAPE-HF2 (10.9 [CI: 6.8–15.0]). In contrast, MITRA-FR assessed QoL using the EuroQol 5-Dimension questionnaire, reporting baseline and endpoint scores. No significant improvements in QoL were observed at 12 months (MD 4.2 CI -1.43; 9.83), a trend that persisted at 2 years. To integrate MITRA-FR into the meta-analysis, estimates of change from baseline were calculated using the difference between the reported baseline and endpoint scores. When pooled with data from COAPT and RESHAPE-HF2, the meta-analysis showed a moderate-to-large overall effect size favoring MTEER (SMD 0.84 CI: 0.33; 1.36, p < 0.001).</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Discussion</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">It’s important to note that the use of different QoL assessment tools contributes to heterogeneity. A considerable amount of missing follow-up data limits the analyses. However, the pooled analysis highlights the potential of MTEER to improve QoL in patients with HF and SMR, mainly driven by the findings of COAPT and RESHAPE-HF2. These results support MTEER as an effective intervention for improving QoL in SMR with HF patients when compared with GDMT, with sustained benefits over time.</span></span></p>
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