Clinical Cardiology Alert – April 1, 2025

Durability of Mitral Valve Repair for Degenerative Mitral Regurgitation

A large, single-center, contemporary long-term follow-up of degenerative mitral valve disease patients undergoing mitral valve repair surgery has shown that 30-day post-operative mortality is < 1% and a median almost nine-year follow-up survival is 90%. Somewhat worse outcomes were observed in those with preoperative symptoms, reduced left ventricular function, atrial fibrillation, and isolated anterior leaflet disease.

DanGer Shock Trial Post-Hoc Analysis: Microaxial Pump Risks May Outweigh Benefits

In this post-hoc analysis of the DanGer Shock trial, patients in the highest quartile of age appeared to have higher mortality compared with younger patients, suggesting less benefit from routine application of the microaxial flow pump in older patients with acute myocardial infarction-related cardiogenic shock.

Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation

An integrated nationwide medical and pharmacy claims database analysis of patients with new atrial fibrillation undergoing catheter ablation as first-line therapy has shown that 17% of patients required repeat ablation for recurrent atrial fibrillation despite the frequent use of antiarrhythmic drugs.

Ten-Year Outcomes of the SCOT-HEART Study

The 10-year follow-up of the SCOT-HEART Study of new-onset chest pain patients randomized to standard care vs. the addition of coronary computed tomography angiography (CTA) has shown that coronary heart disease-related death, myocardial infarction, and other adverse cardiovascular outcomes are reduced with CTA use, perhaps because preventive therapy is increased.

Importance of Dynamic Mitral Regurgitation in Ischemic Cardiomyopathy

A small observational study of patients with ischemic cardiomyopathy and mitral valve regurgitation referred for exercise testing who underwent isometric handgrip exercise showed that the baseline presence or development of severe mitral regurgitation with exercise was predictive of a composite adverse outcome endpoint at one year.