Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral Registry
Background In patients with sarcoidosis, cardiac involvement is a crucial prognostic factor leading to severe cardiovascular events. Mitral regurgitation (MR) predisposes patients to drug‐refractory heart failure; however, MR in patients with cardiac sarcoidosis (CS) has been scarcely investigated a...
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2025-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.039243 |
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| author | Takashi Hiruma Mike Saji Mamoru Nanasato Itaru Takamisawa Ryosuke Higuchi Yuki Izumi Ryo Abe Mitsuaki Isobe Masanori Yamamoto Shunsuke Kubo Masahiko Asami Yusuke Enta Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bota Yohei Ohno Daisuke Hachinohe Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Toshiaki Otsuka Kentaro Hayashida |
| author_facet | Takashi Hiruma Mike Saji Mamoru Nanasato Itaru Takamisawa Ryosuke Higuchi Yuki Izumi Ryo Abe Mitsuaki Isobe Masanori Yamamoto Shunsuke Kubo Masahiko Asami Yusuke Enta Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bota Yohei Ohno Daisuke Hachinohe Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Toshiaki Otsuka Kentaro Hayashida |
| author_sort | Takashi Hiruma |
| collection | DOAJ |
| description | Background In patients with sarcoidosis, cardiac involvement is a crucial prognostic factor leading to severe cardiovascular events. Mitral regurgitation (MR) predisposes patients to drug‐refractory heart failure; however, MR in patients with cardiac sarcoidosis (CS) has been scarcely investigated and its therapeutic approach remains unclear. This study aimed to investigate the clinical impact of transcatheter edge‐to‐edge repair in patients with CS. Methods Patients with CS‐related ventricular functional MR were compared with those with other nonischemic cardiomyopathies in the OCEAN (Optimized Catheter Valvular Intervention)‐Mitral registry in Japan. Results Among 1240 patients with nonischemic cardiomyopathy‐related ventricular functional MR, 40 (3.2%) had CS. Of these, 18 patients (45.0%) had immunosuppressive therapy. Twenty‐seven patients (67.5%) were New York Heart Association function class III/IV. Patients with CS were more likely to be younger and female, had a higher prevalence of ventricular tachyarrhythmia and cardiac resynchronization therapy, and had a larger left ventricle with more severe MR than the others. At the procedure, 38 patients (95.0%) had devices placed at the central lesion. All patients with CS were successfully treated, leading to immediate improvement of cardiac output. At 1‐year follow‐up, 89.3% had MR ≤2+ and 40.0% had New York Heart Association function class I. Despite similar outcomes between groups, greater remnant MR and fatal arrhythmic events in those with CS may be due to inadequate reverse remodeling and ongoing left ventricle damage caused by inflammation. Conclusions Transcatheter edge‐to‐edge repair is an effective heart failure treatment for patients with CS‐related MR; however, the drug‐ and cardiac device‐refractory cardiomyopathy in this population warrants careful management. Registration URL: www.umin.ac.jp/english/; Unique Identifier: UMIN000023653. |
| format | Article |
| id | doaj-art-08c273cc75b9449dadfd271ada8e44f5 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-08c273cc75b9449dadfd271ada8e44f52025-08-20T03:07:46ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-04-0114710.1161/JAHA.124.039243Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral RegistryTakashi Hiruma0Mike Saji1Mamoru Nanasato2Itaru Takamisawa3Ryosuke Higuchi4Yuki Izumi5Ryo Abe6Mitsuaki Isobe7Masanori Yamamoto8Shunsuke Kubo9Masahiko Asami10Yusuke Enta11Shinichi Shirai12Masaki Izumo13Shingo Mizuno14Yusuke Watanabe15Makoto Amaki16Kazuhisa Kodama17Junichi Yamaguchi18Toru Naganuma19Hiroki Bota20Yohei Ohno21Daisuke Hachinohe22Masahiro Yamawaki23Hiroshi Ueno24Kazuki Mizutani25Toshiaki Otsuka26Kentaro Hayashida27Department of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Toyohashi Heart Center Toyohashi JapanDepartment of Cardiology Kurashiki Central Hospital Kurashiki JapanDivision of Cardiology Mitsui Memorial Hospital Tokyo JapanDepartment of Cardiology Sendai Kosei Hospital Sendai JapanDivision of Cardiology Kokura Memorial Hospital Kitakyushu JapanDivision of Cardiology St. Marianna University School of Medicine Hospital Kawasaki JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura Kanagawa JapanDepartment of Cardiology Teikyo University School of Medicine Tokyo JapanDepartment of Cardiology National Cerebral and Cardiovascular Center Suita JapanDivision of Cardiology Saiseikai Kumamoto Hospital Cardiovascular Center Kumamoto JapanDepartment of Cardiology Tokyo Woman’s Medical University Tokyo JapanDepartment of Cardiology New Tokyo Hospital Chiba JapanDepartment of Cardiology Sapporo Higashi Tokushukai Hospital Sapporo JapanDepartment of Cardiology Tokai University School of Medicine Isehara JapanDepartment of Cardiology Sapporo Heart Center, Sapporo Cardio Vascular Clinic Sapporo JapanDepartment of Cardiology Saiseikai Yokohama City Eastern Hospital Yokohama Kanagawa JapanSecond Department of Internal Medicine Toyama University Hospital Toyama JapanDivision of Cardiology, Department of Medicine Kindai University Faculty of Medicine Osaka JapanDepartment of Hygiene and Public Health Nippon Medical School Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanBackground In patients with sarcoidosis, cardiac involvement is a crucial prognostic factor leading to severe cardiovascular events. Mitral regurgitation (MR) predisposes patients to drug‐refractory heart failure; however, MR in patients with cardiac sarcoidosis (CS) has been scarcely investigated and its therapeutic approach remains unclear. This study aimed to investigate the clinical impact of transcatheter edge‐to‐edge repair in patients with CS. Methods Patients with CS‐related ventricular functional MR were compared with those with other nonischemic cardiomyopathies in the OCEAN (Optimized Catheter Valvular Intervention)‐Mitral registry in Japan. Results Among 1240 patients with nonischemic cardiomyopathy‐related ventricular functional MR, 40 (3.2%) had CS. Of these, 18 patients (45.0%) had immunosuppressive therapy. Twenty‐seven patients (67.5%) were New York Heart Association function class III/IV. Patients with CS were more likely to be younger and female, had a higher prevalence of ventricular tachyarrhythmia and cardiac resynchronization therapy, and had a larger left ventricle with more severe MR than the others. At the procedure, 38 patients (95.0%) had devices placed at the central lesion. All patients with CS were successfully treated, leading to immediate improvement of cardiac output. At 1‐year follow‐up, 89.3% had MR ≤2+ and 40.0% had New York Heart Association function class I. Despite similar outcomes between groups, greater remnant MR and fatal arrhythmic events in those with CS may be due to inadequate reverse remodeling and ongoing left ventricle damage caused by inflammation. Conclusions Transcatheter edge‐to‐edge repair is an effective heart failure treatment for patients with CS‐related MR; however, the drug‐ and cardiac device‐refractory cardiomyopathy in this population warrants careful management. Registration URL: www.umin.ac.jp/english/; Unique Identifier: UMIN000023653.https://www.ahajournals.org/doi/10.1161/JAHA.124.039243cardiac sarcoidosisMitraClipmitral regurgitationtranscatheter edge‐to‐edge repair |
| spellingShingle | Takashi Hiruma Mike Saji Mamoru Nanasato Itaru Takamisawa Ryosuke Higuchi Yuki Izumi Ryo Abe Mitsuaki Isobe Masanori Yamamoto Shunsuke Kubo Masahiko Asami Yusuke Enta Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bota Yohei Ohno Daisuke Hachinohe Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Toshiaki Otsuka Kentaro Hayashida Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral Registry Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac sarcoidosis MitraClip mitral regurgitation transcatheter edge‐to‐edge repair |
| title | Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral Registry |
| title_full | Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral Registry |
| title_fullStr | Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral Registry |
| title_full_unstemmed | Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral Registry |
| title_short | Impact of Transcatheter Edge‐to‐Edge Repair in Patients With Cardiac Sarcoidosis: Insights From the OCEAN‐Mitral Registry |
| title_sort | impact of transcatheter edge to edge repair in patients with cardiac sarcoidosis insights from the ocean mitral registry |
| topic | cardiac sarcoidosis MitraClip mitral regurgitation transcatheter edge‐to‐edge repair |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.039243 |
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