Transcatheter treatment of secondary mitral regurgitation in chronic heart failure

Marianna Adamo


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    Secondary mitral regurgitation (SMR) is common in patients with chronic heart failure (HF) and associated with poor outcome. Current guidelines recommend transcatheter edge to edge mitral valve repair (M-TEER) in selected patients with SMR. However, the role of SMR in HF pathophysiology and patient selection for M-TEER are still debated.
    In part 1 of this thesis, the role of SMR in chronic HF was explored through two analyses of BIOSTAT-CHF, a large prospective multicentre study including patients with either new-onset or worsening chronic HF.
    In Part 2 of this thesis, we focused on invasive treatment of SMR by means of M-TEER, which is, to date, the most widely used procedure. In Chapter 4 and 5 we aimed at evaluating how to select patients for M-TEER in the real-world.
    In Chapter 6 and 7 we explored the role of right ventricular function and tricuspid regurgitation in a large population receiving M-TEER at 13 European centres.
    The hypothesis behind Chapter 8 was that M-TEER, increasing systemic cardiac output, may improve hemodynamics with beneficial effects on blood pressure and renal function, which may allow to further optimize GDMT.
    In conclusion, this thesis confirms the prognostic role of SMR in chronic HF and provides several proofs of concept regarding patient selection for M-TEER.
    Originele taal-2English
    KwalificatieDoctor of Philosophy
    Toekennende instantie
    • Rijksuniversiteit Groningen
    • Voors, Adriaan, Supervisor
    • Metra, Macro, Supervisor, Externe Persoon
    • Lipsic, Erik, Supervisor
    Datum van toekenning4-mrt.-2024
    Plaats van publicatie[Groningen]
    StatusPublished - 2024


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