Currently, transcatheter mitral valve repair (TMR) using the MitraClip device has become a complementary approach to medical therapy for functional mitral regurgitation (MR). Functional MR arises from valvular deformation secondary to ventricular or atrial abnormalities. The mechanisms described include left ventricular dilation or dysfunction associated with adverse ventricular remodelling.
According to the clinical practice guidelines on valvular heart disease issued by the European Society of Cardiology, intervention on the mitral valve in patients with severe functional MR is indicated with a Class I recommendation when symptoms persist despite optimal medical therapy.
This descriptive study gathers data concerning the medical treatments patients were receiving prior to undergoing TMR, stratified by the degree of ventricular dysfunction. The aim is to assess whether patients were receiving optimal medical therapy at the time of intervention.
The study population comprised 207 patients who underwent TMR at the Central University Hospital of Asturias between October 2015 and February 2024. Of the total cohort, 79 patients had a preserved left ventricular ejection fraction (LVEF ≥ 50%), 37 had mildly impaired LVEF (41–49%), and 91 had reduced LVEF (≤ 40%).
Patients were categorised according to their LVEF in order to evaluate whether they were on optimal medical therapy, specifically quadruple therapy as recommended in the European Society of Cardiology guidelines for heart failure. The findings are presented in Table 1.
As observed, a high proportion of patients with reduced LVEF were receiving optimal medical therapy. However, these findings are limited by the fact that the most recent guidelines, as previously mentioned, were published in 2023; consequently, the majority of patients had been prescribed their treatment several years earlier.
