Prognostic value of left ventricular pressure-volume loops during MitraClip therapy

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K17082
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Hiroshima University
• Principal Investigator: Ikenaga Hiroki 広島大学, 医系科学研究科(医), 助教 (80815853)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: MitraClip / Mitral regurgitation / PV loops / TEER

Outline of Final Research Achievements

Mitral valve transcatheter edge-to-edge repair (MitraClip) has been reported to significantly reduce heart failure hospitalization and death in patients with severe secondary mitral regurgitation (MR). However, there are cases in which cardiac function does not improve after MitraClip, and the elucidation of factors that contribute to the long-term benefit of MitraClip is an issue for the future.
In this study, using a PV combination catheter that can continuously and directly measure left ventricular pressure and volume, we generated left ventricular pressure-volume loops before and after MitraClip in patients with secondary MR, and evaluated changes in left ventricular function and hemodynamics. Furthermore, long-term prognosis was followed to elucidate influencing factors.

Free Research Field

Cardiology

Academic Significance and Societal Importance of the Research Achievements

左室圧容積曲線からは左室の収縮性、拡張性、前負荷/後負荷、心筋酸素消費量、心仕事量など左室の状態を詳細に評価が可能であり、マイトラクリップ術の有用性が期待できる患者を判定できるようになれば社会的にも大きく貢献できる。また手技中のエンドポイントを左室圧容積曲線を基に設定できるようになれば、最適な治療を個々の症例で行えることができる。本研究の成果は2次性MRに対してマイトラクリップ術が有用な患者の選択、マイトラクリップ術の手技のエンドポイントの設定を可能とし、予後向上につながるものである。