Table 2.
Echocardiographic and Procedural Variables According to LAP Reduction and Postprocedural MnG
| Parameter | All Patients (n=112) | LAP Reduction | MnG Postprocedure | ||||
|---|---|---|---|---|---|---|---|
| Optimal LAP Reduction (n=29) | Lower LAP Reduction (n=83) | P Value | MnG >5 mm Hg (n=19) | MnG ≤5 mm Hg (n=93) | P Value | ||
| LV EF, % | 51±14 | 51±15 | 52±13 | 0.82 | 54±14 | 51±14 | 0.40 |
| End‐diastolic diameter, mm | 56±8 | 57±9 | 56±8 | 0.75 | 54±8 | 57±8 | 0.17 |
| LAVI, mL/m2 | 65±21 | 62±16 | 67±22 | 0.16 | 58±15 | 67±21 | 0.05 |
| RVSP, mm Hg | 53±15 | 55±19 | 53±14 | 0.67 | 53±13 | 53±15 | 0.94 |
| Preprocedure mean diastolic gradient, mm Hga | 2±1 | 2±2 | 2±1 | 0.94 | 3±1 | 2±1 | 0.01 |
| Preprocedure MR severity | 0.09 | 0.53 | |||||
| Grade 3/4 | 18 (16) | 2 (7) | 16 (19) | 4 (21) | 14 (15) | ||
| Grade 4/4 | 94 (84) | 27 (93) | 67 (81) | 15 (79) | 79 (85) | ||
| Preprocedure ERO, cm2 | 0.45±0.15 | 0.50±0.16 | 0.43±0.15 | 0.05 | 0.38±0.11 | 0.46±0.16 | 0.02 |
| Preprocedure RV, mL | 68±21 | 76±22 | 66±20 | 0.06 | 62±12 | 70±22 | 0.06 |
| Postprocedure MR severity | 0.04 | 0.06 | |||||
| Grade 1/4 | 71 (63) | 23 (79) | 47 (57) | 7 (37) | 63 (68) | ||
| Grade 2/4 | 33 (29) | 6 (21) | 27 (33) | 9 (47) | 24 (26) | ||
| Grade 3/4 | 4 (4) | 0 (0) | 4 (5) | 2 (11) | 2 (2) | ||
| Grade 4/4 | 5 (4) | 0 (0) | 5 (6) | 1 (5) | 4 (4) | ||
| Flail scallop | 46 (41) | 19 (66) | 27 (33) | 0.002 | 7 (36) | 39 (42) | 0.80 |
| Flail gap >10 mm | 3 (3) | 2 (7) | 1 (1) | 0.13 | 0 (0) | 3 (3) | >0.99 |
| Flail width >15 mm | 9 (8) | 4 (14) | 5 (6) | 0.21 | 0 (0) | 9 (9) | 0.35 |
| Flail gap >10 mm or flail width >15 mm | 12 (11) | 6 (21) | 6 (7) | 0.06 | 0 (0) | 12 (13) | 0.21 |
| A2‐P2 jet origin | 73 (65) | 23 (79) | 50 (60) | 0.06 | 14 (74) | 59 (63) | 0.38 |
| Multiple regurgitant jets | 51 (46) | 10 (34) | 41 (49) | 0.16 | 13 (68) | 38 (41) | 0.03 |
| >1 Jet involving at least 2 scallops | 39 (35) | 5 (17) | 34 (41) | 0.02 | 11 (58) | 28 (30) | 0.02 |
| Maximum jet width, mm | 10±4 | 10±4 | 10±4 | 0.73 | 9±3 | 10±4 | 0.12 |
| PML length, mm | 15±4 | 15±4 | 14±3 | 0.11 | 14±3 | 15±4 | 0.34 |
| Commissural involvement | 6 (5) | 1 (4) | 5 (6) | 0.60 | 0 (0) | 6 (7) | 0.59 |
| Mitral annular calcification | 49 (44) | 14 (48) | 35 (42) | 0.57 | 15 (79) | 34 (37) | 0.0009 |
| Calcified mitral leaflets | 23 (21) | 3 (10) | 20 (24) | 0.10 | 6 (32) | 17 (18) | 0.22 |
| Redundant leaflets with ≥50% leaflet prolapse | 14 (13) | 4 (14) | 10 (12) | 0.81 | 1 (5) | 13 (14) | 0.46 |
| PML CLI | 54 (51) | 18 (64) | 36 (46) | 0.10 | 7 (47) | 47 (52) | 0.72 |
| 2D echo image quality | 0.32 | 0.35 | |||||
| Suboptimal | 2 (2) | 0 (0) | 2 (2) | 1 (5) | 1 (1) | ||
| Good | 62 (55) | 14 (48) | 48 (58) | 12 (63) | 50 (54) | ||
| Excellent | 48 (43) | 15 (52) | 33 (40) | 6 (32) | 42 (45) | ||
| 3D echo image quality | 0.04 | 0.75 | |||||
| Suboptimal | 23 (21) | 2 (7) | 21 (25) | 5 (26) | 18 (19) | ||
| Good | 60 (54) | 16 (55) | 44 (53) | 10 (53) | 50 (54) | ||
| Excellent | 29 (26) | 11 (38) | 18 (22) | 4 (21) | 25 (27) | ||
| Postprocedure mean diastolic gradient, mm Hg | 4±2 | 4±1 | 4±2 | 0.32 | 7±1 | 3±1 | <0.0001 |
| Postprocedure heart rate, bpm | 73±14 | 73±13 | 73±14 | 0.82 | 77±14 | 72±14 | 0.22 |
| >1 Clip deployed | 44 (40) | 11 (39) | 33 (41) | 0.89 | 13 (68) | 31 (34) | 0.006 |
| Postprocedure NYHA functional classb | 0.01 | 0.24 | |||||
| I | 54 (53) | 20 (77) | 34 (45) | 10 (59) | 44 (52) | ||
| II | 31 (30) | 4 (15) | 27 (36) | 2 (12) | 29 (34) | ||
| III | 15 (15) | 1 (4) | 14 (18) | 4 (24) | 11 (13) | ||
| IV | 2 (2) | 1 (4) | 1 (1) | 1 (6) | 1 (1) | ||
Values are displayed as number (percentage) or mean±SD. 2D indicates 2 dimensional; 3D, 3 dimensional; bpm, beats per minute; CLI, cleft‐like indentation; EF, ejection fraction; ERO, estimated regurgitant orifice; LAP, left atrial pressure; LAVI, left atrial volume index; LV, left ventricular; MnG, mean diastolic gradient; MR, mitral regurgitation; NYHA, New York Heart Association; PML, posterior mitral leaflet; RV, regurgitant volume; and RVSP, right ventricular systolic pressure.
a
Preprocedure MnG available in 55 patients.
b
Postprocedure NYHA class available in 102 patients.