Changes in serum biomarker profiles after percutaneous mitral valve repair with the MitraClip system

Cardiol J. 2016;23(4):384-92. doi: 10.5603/CJ.a2016.0024. Epub 2016 Jun 14.

Abstract

Background: Mitral regurgitation (MR) is one of the most common valvular diseases. Percu-taneous mitral valve repair with the MitraClipTM system is a novel percutaneous mitral valve repair (PMVR) technique for high-surgical-risk patients. However, the effect of PMVR on cir-culating cardiac or inflammatory biomarkers and their association with individual functional, echocardiographic and clinical outcomes is poorly investigated.

Methods: A group of 144 patients with functional or degenerative MR (age, 75 ± 11 years; 41% females) underwent PMVR with the MitraClip system at the University Heart Center Zu-rich. Serum biomarkers as N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP) and creatinine were obtained from venous sampling at baseline and follow-up of 3-6 months.

Results: Median NT-proBNP decreased insignificantly from 2,942 (IQR 1,596-5,722) to 2,739 (IQR 1,440-4,296) ng/L, p = 0.21. NT-proBNP changes did not correlate with baseline left ventricular (LV) ejection fraction or LV dimensions, with New York Heart Association class on follow-up, or with clinical events on follow-up. CRP levels reached a peak on the third postoperative day at 34.0 mg/L with a subsequent slow decrease over the ensuing days.

Conclusions: Despite successful PMVR, NT-proBNP remain fairly unchanged on follow-up and changes in NT-proBNP levels are poor predictors of functional improvement or clinical outcome after MitraClip treatment.

Keywords: MitraClip; NT-proBNP; mitral regurgitation; percutaneous mitral valve repair; serum biomarkers.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Cardiac Catheterization / methods*
  • Echocardiography
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / blood
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / surgery*
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Postoperative Period
  • Prognosis
  • Prosthesis Design
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • C-Reactive Protein