Abstract 10388: Impact Of Right Ventricular Function On Cardiopulmonary Exercise Capacity In Mitral Regurgitation Patients Undergoing Transcatheter Mitral Valve Repair

Background/Objectives: To investigate the role of right ventricular (RV) function on exercise capacity in patients undergoing transcatheter mitral valve repair (TMVR) we aimed to perform cardiopulmonary exercise testing (CPET) and to show a correlation between an improved RV function and maximal and submaximal exercise capacity. Methods: Constant work rate exercise time testing (CWRET) reflects submaximal/endurance exercise capacity, which is more likely to be relevant for daily life activities, and gives a more differentiated physiologic insight into the nature of exercise intolerance. Thus, 28 Patients with mitral regurgitation (MR) and symptomatic heart failure (NYHA≥II) underwent CPET by assessment of maximal oxygen uptake (peak VO 2 ) and submaximal exercise capacity (at 75% of maximal achieved work rate in the initial incremental exercise test) accompanied by echocardiography prior to TMVR and 3 months post-procedure. Results: Mean age of the patients was 75.0±8.7 years and 32.1% of them were female. One patient presented a reduction of MR <2 grades. RV function (assessed with fractional area change, tricuspid annular plane systolic excursion, longitudinal strain of the RV free wall and S`) was at least moderately impaired in 25% of the patients. The submaximal exercise capacity of these patients was impaired, but did not significantly differ (416.4±359.6sec vs. 296.1 ±216.5sec; p=0.152) compared to patients without a deteriorated RV function. Three months after intervention, exercise time at 75% of maximal achieved work rate significantly improved (from 337.4±262.2sec to 517.4±393. sec p=0.006), reflecting a gain in submaximal exercise tolerance. peak VO 2 showed a positive trend, but no statistically significant difference (10.3±3.1ml/min/kg vs. 11.3±3.4ml/min/kg; p=0.056). RV function (at least 2 of 4 parameters) improved in 35.7% and these patients showed a significantly higher submaximal exercise time increasement (471.7±153.9sec vs. 82.7±47.0sec, p=0.003). Discussion/Conclusions: TMVR may have a beneficial effect on RV remodeling. Furthermore, submaximal exercise capacity is significantly increased, reflecting an improvement especially regarding daily life activities in MR patients and impaired RV function.