Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
|Impact of individual frailty domains on outcomes in patients undergoing transcatheter edge-to-edge mitral valve repair|
|C. Metze1, C. Iliadis1, M. I. Körber1, A. Kalkan1, L. Ochs1, M. Brüwer1, S. Baldus1, R. Pfister1|
|1Klinik für Kardiologie, Angiologie, Pneumologie und Internistische Intensivmedizin, Herzzentrum der Universität zu Köln, Köln;|
Frailty is a complex multidimensional syndrome which is common in patients undergoing percutaneous mitral valve repair (PMVR) and associated with adverse outcomes. Still, there are no data available on the differential impact of individual frailty domains.
Procedural success (a reduction of mitral regurgitation to grade 2 or lower) and complications did not differ between patients affected and not affected by frailty domains. The length of hospital stay was longer in slow, weak (each p<0.01) and inactive (p=0.02) patients.
Clinically relevant improvement in functional tests (defined as improvement of ≥ 50 m in 6 MWT, ≥ 5 points in SF-36 and ≥ 8 points in MLWHFQ) was more pronounced in exhausted (SF-36 PCS, MLWHFQ), slow (6 MWT, MLWHFQ) and inactive (SF-36 PCS and MCS, MLWHFQ) patients.
1-year mortality was higher in exhausted, slow, weak (each p<0.01) and inactive (p=0,02) patients.
The combined endpoint of 1-year survival with symptomatic benefit (improvement of ≥ 8 points in MLWHFQ after 6 weeks) was significantly more often reached in exhausted (p<0.01) and inactive (p=0.03) patients.
The hazard ratio for death during a median long-term follow-up time of 517 days was significantly higher for exhausted, slow, weak, and inactive patients. Exhaustion and slowness remained a significant influencing factor after adjustment for NT-proBNP levels, NYHA-class, and age.