蒋越,潘文志,周达新

• 1:复旦大学附属中山医院心内科上海市心血管病研究所国家放射与治疗临床医学研究中心

摘要(Abstract)：

二尖瓣反流是目前最常见的心脏瓣膜疾病之一，在人群中发病率约为10%，其中大部分为功能性反流。室性功能性二尖瓣反流（V-FMR）患者是由于左心室收缩功能减弱合并左心室扩大，导致瓣环扩大及相对性的腱索牵拉拴系所致，由于该类患者心功能及基础情况较差，手术风险及预后均不如常规二尖瓣反流患者。近年来，经导管二尖瓣缘对缘修复术逐渐发展为一项成熟的二尖瓣反流介入技术，在V-FMR患者中取得了良好的临床结果，为V-FMR的治疗提供了新的选择。

关键词(KeyWords)： 二尖瓣反流;室性功能性二尖瓣反流;经导管二尖瓣缘对缘修复术;介入治疗

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划资助项目（2020YFC2008100）

作者(Author): 蒋越,潘文志,周达新

参考文献(References)：

• [1]丁建东,马根山.心力衰竭合并瓣膜性心脏病介入治疗研究现状[J].中国实用内科杂志,2020,40(12):990-995.DOI:10.19538/j.nk2020120106.
• [2]Dziadzko V,Dziadzko M,Medina-Inojosa JR,et al.Causes and mechanisms of isolated mitral regurgitation in the community:clinical context and outcome[J].Eur Heart J,2019,40(27):2194-2202.DOI:10.1093/eurheartj/ehz314.
• [3]Otto CM,Nishimura RA,Bonow RO,et al.2020 ACC/AHA guideline for the management of patients with valvular heart disease:executive summary:a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines[J].Circulation,2021,143(5):e3 5-e71.DOI:10.1161/CIR.0000000000000932.
• [4]Vahanian A,Beyersdorf F,Praz E,et al.2021 ESC/EACTS guidelines for the management of valvular heart disease[J].Eur Heart J,2022,43(7):561-632.DOI:10.1093/eurheartj/ebab395.
• [5]中国医师协会心血管内科医师分会结构性心脏病学组,亚太结构性心脏病俱乐部.中国经导管二尖瓣缘对缘修复术临床路径(2022版)精简版[J].中国介入心脏病学杂志,2023,31(3):161-173.DOI:10.3969/j.issn.1004-8812.2023.03.001.
• [6]Hung JW.Ischemic(functional)mitral regurgitation[J].Cardiol Clin,2013,31(2):231-236.DOI:10.1016/j.ccl.2013.04.003.
• [7]Otsuji Y,Kumanohoso T.Yoshifuku S,et al.Isolated annular dilation does not usually cause important functional mitral regurgitation:comparison between patients with lone atrial fibrillation and those with idiopathic or ischemic cardiomyopathy[J].J Am Coll Cardiol,2002,39(10):1651-1656.DOI:10.1016/S0735-1097(02)01838-7.
• [8]Kumanohoso T,Otsuji Y,Yoshifuku S,et al.Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction:quantitative analysis of left ventricular and mitral valve geometry in 103 patients with prior myocardial infarction[J].J Thorac Cardiovasc Surg,2003,125(1):135-143.DOI:10.1067/mtc.2003.78.
• [9]Furukawa A,Abe Y,Ito K,et al.Mechanisms of changes in functional mitral regurgitation by preload alterations[J].J Cardiol,2018,71(6):570-576.DOI:10.1016/j.jjcc.2017.12.005.
• [10]Carpentier A.Cardiac valve surgery--the"French correction"[J].J Thorac Cardiovasc Surg,1983,86(3):323-337.
• [11]Stone GW,Lindenfeld J,Abraham WT,et al.Transcatheter mitral-valve repair in patients with heart failure[J].N Engl J Med,2018,379(24):2307-2318.DOI:10.1056/NEJMoa1806640.
• [12]Detaint D,Sundt TM,Nkomo VT,et al.Surgical correction of mitral regurgitation in the elderly:outcomes and recent improvements[J].Circulation,2006,114(4):265-272.DOI:10.1161/CIRCULATIONAHA.106.619239.
• [13]Ruiz CE,Hahn RT,Berrebi A,et al.Clinical trial principles and endpoint definitions for paravalvular leaks in surgical prosthesis:an expert statement[J].J Am Coll Cardiol,2017,69(16):2067-2087.DOI:10.1016/j.jacc.2017:02.038.
• [14]Goldstone AB,Chiu P,Baiocchi M,et al.Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement[J].N Engl J Med,2017,377(19):1847-1857.DOI:10.1056/NEJMoa1613792.
• [15]中华医学会心血管病学分会.经导管二尖瓣缘对缘修复术的中国专家共识[J].中华心血管病杂志,2022,50(9):853-863.DOI:10.3760/cma.j.cn112148-20211212-01067.
• [16]Doldi PM,Stolz L,Kalbacher D,et al.Right ventricular dysfunction predicts outcome after transcatheter mitral valve repair for primary mitral valve regurgitation[J].Eur J Heart Fail,2022,24(11):2162-2171.DOI:10.1002/ejhf.2661.
• [17]Obadia JF,Messika-Zeitoun D,Leurent G,et al.Percutaneousrepair or medical treatment for secondary mitral regurgitation[J].N Engl J Med,2018,379(24):2297-2306.DOI:10.1056/NEJMoa1805374.
• [18]Braun J,Bax JJ,Versteegh MI,et al.Preoperative left ventricular dimensions predict reverse remodeling following restrictive mitral annuloplasty in ischemic mitral regurgitation[J].Eur J Cardiothorac Surg,2005,27(5):847-853,DOI:10.1016/j.ej cts.2004.12.031.
• [19]Braun J,van de Veire NR,Klautz RJ,et al.Restrictive mitral annuloplasty cures ischemic mitral regurgitation and heart failure[J].Ann Thorac Surg,2008,85(2):430-436.DOI:10.1016/j.athoracsur.2007.08.040.
• [20]Pibarot P,Delgado V,Bax JJ.MITRA-FR vs.COAPT:lessons from two trials with diametrically opposed results[J].Eur Heart J Cardiovasc Imaging,2019,20(6):620-624.DOI:10.1093/ehjci/jez073.
• [21]龙愉良,潘文志,周达新.功能性二尖瓣反流介入治疗的争议与进展[J].中华心血管病杂志(网络版),2021,4(1):1-5.DOI:10.3760/cma.j.issn.2096-1588.2021.1000073.
• [22]Stone GW,Abraham WT,Lindenfeld J,et al.Fiveyear follow-up after transcatheter repair of secondary mitral regurgitation[J].N Engl J Med,2023,388(22):2037-2048.DOI:10,1056/NEJMoa2300213,
• [23]Feldman T,Kar S,Rinaldi M,et al.Percutaneous mitral repair with the MitraClip system:safety and midterm durability in the initial EVEREST(Endovascular Valve Edge-to-Edge REpair Study)cohort[J].J Am Coll Cardiol,2009,54(8):686-694.DOI:10.1016/j.jacc.2009.03.077.
• [241 Whitlow PL,Feldman T,Pedersen WR,et al.Acute and12-month results with catheter-based mitral valve leaflet repair:the EVERESTⅡ(Endovascular Valve Edge-to-Edge Repair)high risk study[J].J Am Coll Cardiol,2012,59(2):130-139.DOI:10.1016/j.j acc.2011.08.067.
• [25]Yoon SH,Makar M,Kar S,et al.Prognostic value of increased mitral valve gradient after transcatheter edge-to-edge repair for primary mitral regurgitation[J].JACC Cardiovasc Interv,2022,15(9):935-945.DOI:10.1016/j.jcin.2022.01.281.
• [26]Koell B,Ludwig S,Weimann J,et al.Long-term outcomes of patients with elevated mitral valve pressure gradient after mitral valve edge-to-edge repair[J].JACC Cardiovasc Interv,2022,15(9):922-934.DOI:10.1016/j.jcin.2021.12.007.
• [27]Halaby R,Herrmann HC,Gertz ZM,et al.Effect of mitral valve gradient after mitraclip on outcomes in secondary mitral regurgitation:results from the COAPT trial[J].JACC Cardiovasc Interv,2021,14(8):879-889.DOI:10.1016/j.jcin,2021,01,049.
• [28]Reichart D,Kalbacher D.Rubsamen N,et al.The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation[J].Eur J Heart Fail,2020,22(10):1840-1848.DOI:10.1002/ejhf.1774.
• [29]Orban M,Karam N,Lubos E,et al.Impact of proportionality of secondary mitral regurgitation on outcome after transcatheter mitral valve repair[J].JACC Cardiovasc Imaging,2021,14(4):715-725.DOI:10.1016/j.jcmg.2020.05.042.
• [30]Higuchi S,Orban M,Stolz L,et al.Impact of residual mitral regurgitation on survival after transcatheter edge-to-edge repair for secondaiy mitral regurgitation[J].JACC Cardiovasc Interv,2021,14(11):1243-1253.DOI:10.1016/j.jcin.2021.03.050.
• [31]Lindman BR,Asch FM,Grayburn PA,et al.Ventricular remodeling and outcomes after mitral transcatheter edge-to-edge repair in heart failure:the COAPT trial[J].JACC Cardiovasc Interv,2023,16(10):1160-1172.DOI:10.1016/j.jcin.2023.02.031.
• [32]Scotti A,Coisne A,Granada JF,et al.Impact of malnutrition in patients with heart failure and secondary mitral regurgitation:the COAPT trial[J].J Am Coll Cardiol,2023,82(2):128-138.DOI:10.1016/j.jacc.2023.04.047.
• [33]Giustino G,Lindenfeld J,Abraham WT,et al.NYHA functional classification and outcomes after transcatheter mitral valve repair in heart failure:the COAPT trial[J].JACC Cardiovasc Interv,2020,13(20):2317-2328.DOI:10.1016/j.jcin.2020.06.058.
• [34]Shah B,Villablanca PA.Vemulapalli S,et al.Outcomes after transcatheter mitral valve repair in patients with renal disease[J].Circ Cardiovasc Interv,2019,12(2):e007552.DOI:10.1161/CIRCIN TERVENTIONS.118.007552.
• [35]Sisinni A,Munafo A,Pivato CA,et al.Effect of chronic kidney disease on 5-year outcome in patients with heart failure and secondary mitral regurgitation undergoing percutaneous MitraClip insertion[J].Am J Cardiol,2022,171:105-114.DOI:10.1016/j.amjcard.2022.01.048.
• [36]Beohar N,Ailawadi G,Kotinkaduwa LN,et al.Impact of baseline renal dysfunction on cardiac outcomes and end-stage renal disease in heart failure patients with mitral regurgitation:the COAPT trial[J].Eur Heart J,2022,43(17):1639-1648.DOI:10.109 3/eurheartj/ehac026.
• [37]Wiebe J,Franke J,Lubos E,et al.Percutaneous mitral valve repair with the MitraClip system according to the predicted risk by the logistic Euro SCORE:preliminary results from the German Transcatheter Mitral Valve Interventions(TRAMI)Registry[J].Catheter Cardiovasc Interv,2014,84(4):591-598.DOI:10.1002/ccd.25493.
• [38]Raposeiras-Roubin S,Adamo M,Freixa X,et al.A score to assess mortality after percutaneous mitral valve repair[J].J Am Coll Cardiol,2022,79(6):562-573.DOI:10.1016/j.jacc.2021.11.041.
• [39]Matsumoto T,Nakamura M,Yeow WL,et al.Impact of pulmonary hypertension on outcomes in patients with functional mitral regurgitation undergoing percutaneous edge-to-edge repair[J].Am J Cardiol,2014,114(11):1735-1739.DOI:10.1016/j.amjcard.2014.08.044.
• [40]Ben-Yehuda O,Shahim B,Chen S,et al.Pulmonary Hypertension in Transcatheter Mitral Valve Repair for Secondary Mitral Regurgitation:The COAPT Trial[J].J Am Coll Cardiol,2020,76(22):2595-2606.DOI:10.1016/j.jacc.2020.09.609.
• [41]Shechter A,Koren O,Skaf S,et al.Transcatheter edge-toedge repair for chronic functional mitral regurgitation in patients with very severe left ventricular dysfunction[J].Am Heart J,2023,264:59-71.DOI:10.1016/j.ahj.2023.05.020.
• [42]Long Y,Pan W,Pan C,et al.Real-time echocardiographic guidance for transcatheter repair noncentral mitral regurgitation using the novel ValveClamp system[J].J Card Surg,2021,36(11):4378-4380.DOI:10.1111/jocs,15905.
• [43]Ge Z,Pan W,Zhou D,et al.Effect of a novel transcatheter edgeto-edge repair device on the three-dimensional geometry of mitral valve in degenerative mitral regurgitation[J].Catheter Cardiovasc Interv,2021,97(1):177-185,DOI:10,1002/ccd.29002.
• [44]Li W,Long Y,Pan W,et al.Transcatheter edge to edge repair using the ease-of-use valve clamp system for functional mitral regurgitation:a primary report[J].Surg Today,2023,53(1):90-97.DOI:10.1007/s00595-022-02559-8.