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Title:

Incidence of systemic inflammatory response syndrome and patient outcome following transcatheter edge-to-edge mitral valve repair.

Document type:
Article; Early Access; Journal Article
Author(s):
Syryca, Finn; Pellegrini, Costanza; Gollreiter, Marie; Nicol, Philipp; Mayr, N Patrick; Alvarez-Covarrubias, Hector A; Altaner, Niklas; Rheude, Tobias; Holdenrieder, Stefan; Schunkert, Heribert; Kastrati, Adnan; Joner, Michael; Xhepa, Erion; Trenkwalder, Teresa
Abstract:
OBJECTIVES: Systemic inflammatory response syndrome (SIRS) is a common finding after cardiovascular interventions. Data on the incidence of SIRS and its impact on outcome in patients undergoing transcatheter edge-to-edge mitral valve repair (MV-TEER) for mitral regurgitation (MR) is lacking. METHODS: From January 2013 to December 2020, 373 patients with moderate or severe MR undergoing MV-TEER were included. SIRS was defined as at least two of the following criteria within 48 h after the procedure: leucocyte count > 12.0 or < 4.0 × 109/l, respiratory rate > 20 breaths per minute or PaCO2 ≤ 4.3 kPa/32 mmHg, heart rate > 90 bpm and temperature > 38.0 °C or < 36.0 °C. The primary endpoint was 3-years all-cause mortality. RESULTS: SIRS was observed in 49.6% (185/373) of patients. Patients who developed SIRS presented more frequently with NYHA III/IV at baseline [SIRS: 82.4% (149/185) vs. no SIRS: 79.0% (147/188); p = 0.029]. Patients who developed SIRS spent more days on ICU (p < 0.001) and overall length of stay was longer (p < 0.001). Relevant residual MR, defined as MR ≥ III in-hospital, was present more often in patients who developed SIRS [SIRS: 11.3% (20/177) vs. no SIRS: 3.93% (7/178), p = 0.036]. At 3 years, all-cause mortality in the entire population was 33.5% (125/373) with an increased all-cause mortality in patients with SIRS compared to patients without SIRS (HR 1.49, [CI 95% 1.04, 2.13]; p = 0.0264). In the multivariate analysis development of SIRS (HR 1.479 [CI 95% 1.016, 2.154]; p = 0.041) was identified as predictor for 3-years all-cause mortality. CONCLUSIONS: SIRS is a common finding after MV-TEER occurring in approximately half of patients. SIRS after MV-TEER was associated with a longer in-hospital stay. In addition, we observed an increased 3-years all-cause mortality in patients with SIRS.
Journal title abbreviation:
Clin Res Cardiol
Year:
2024
Journal volume:
113
Journal issue:
2
Pages contribution:
276-287
Fulltext / DOI:
doi:10.1007/s00392-023-02316-y
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/37870627
Print-ISSN:
1861-0684
TUM Institution:
Klinik für Anästhesiologie (DHM)
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