TY - JOUR
T1 - Monitoring of mitral- and tricuspid valve interventions with CardioMEMS
T2 - insights beyond imaging
AU - Dannenberg, Varius
AU - Koschutnik, Matthias
AU - Donà, Carolina
AU - Nitsche, Christian
AU - Spinka, Georg
AU - Heitzinger, Gregor
AU - Mascherbauer, Katharina
AU - Kammerlander, Andreas
AU - Schneider, Matthias
AU - Winter, Max-Paul
AU - Bartko, Philipp
AU - Goliasch, Georg
AU - Hengstenberg, Christian
AU - Mascherbauer, Julia
AU - Gwechenberger, Marianne
N1 - Funding Information:
Many thanks to Sophie Lindenthal for her assistance with the graphic design.
Publisher Copyright:
© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.
PY - 2023/6
Y1 - 2023/6
N2 - BACKGROUND: Mitral- and tricuspid regurgitation are associated with significant morbidity and mortality and are increasingly treated interventionally. CardioMEMS is a transcutaneously implanted pressure sensor placed in the pulmonary artery that allows invasive measurement of pulmonary artery pressure and cardiac output.METHODS: This proof-of-concept study aimed to observe hemodynamic changes as determined by CardioMEMS after transcatheter atrioventricular valve interventions, assess the additional value of CardioMEMS on top of echocardiography, and investigate a potential effect of CardioMEMS on outcome. Patients treated with transcatheter mitral- or tricuspid valve interventions (mitral: TMVR, tricuspid: TTVR) or bicaval valve implantation (bi-CAVI) were recruited. All patients were followed for 12 months.RESULTS: Thirty-six patients were included (4 with CardioMEMS, 32 controls). Patients with CardioMEMS were monitored prior to intervention and 3-12 months thereafter (one received TMVR, one bi-CAVI, one both TMVR and TTVR, and one isolated TTVR). CardioMEMS group: In both patients with TMVR and in the patient with bi-CAVI, mean pulmonary artery pressures decreased (all p<0.001) and cardiac output increased significantly (both TMVR p<0.001 and bi-CAVI p=0.006) while functional parameters, echocardiography, and NT-proBNP were difficult to interpret, unreliable, or both. Changes after TTVR remained inconclusive.CONCLUSION: Invasive monitoring using CardioMEMS provides important information after mitral- and tricuspid valve interventions. Such data pave the way for a deeper understanding of the prerequisites for optimal patient selection and management for catheter-based interventions.
AB - BACKGROUND: Mitral- and tricuspid regurgitation are associated with significant morbidity and mortality and are increasingly treated interventionally. CardioMEMS is a transcutaneously implanted pressure sensor placed in the pulmonary artery that allows invasive measurement of pulmonary artery pressure and cardiac output.METHODS: This proof-of-concept study aimed to observe hemodynamic changes as determined by CardioMEMS after transcatheter atrioventricular valve interventions, assess the additional value of CardioMEMS on top of echocardiography, and investigate a potential effect of CardioMEMS on outcome. Patients treated with transcatheter mitral- or tricuspid valve interventions (mitral: TMVR, tricuspid: TTVR) or bicaval valve implantation (bi-CAVI) were recruited. All patients were followed for 12 months.RESULTS: Thirty-six patients were included (4 with CardioMEMS, 32 controls). Patients with CardioMEMS were monitored prior to intervention and 3-12 months thereafter (one received TMVR, one bi-CAVI, one both TMVR and TTVR, and one isolated TTVR). CardioMEMS group: In both patients with TMVR and in the patient with bi-CAVI, mean pulmonary artery pressures decreased (all p<0.001) and cardiac output increased significantly (both TMVR p<0.001 and bi-CAVI p=0.006) while functional parameters, echocardiography, and NT-proBNP were difficult to interpret, unreliable, or both. Changes after TTVR remained inconclusive.CONCLUSION: Invasive monitoring using CardioMEMS provides important information after mitral- and tricuspid valve interventions. Such data pave the way for a deeper understanding of the prerequisites for optimal patient selection and management for catheter-based interventions.
KW - cardiac output
KW - mitral- and tricuspid regurgitation
KW - pulmonary hypertension
KW - valvular diseases
UR - http://www.scopus.com/inward/record.url?scp=85147515721&partnerID=8YFLogxK
U2 - 10.1111/eci.13961
DO - 10.1111/eci.13961
M3 - Journal article
C2 - 36710528
SN - 0014-2972
VL - 53
SP - e13961
JO - European Journal of Clinical Investigation
JF - European Journal of Clinical Investigation
IS - 6
M1 - e13961
ER -