Impact of Residual Mitral Regurgitation on Survival After Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation
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Impact of Residual Mitral Regurgitation on Survival After Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation. / Higuchi, Satoshi; Orban, Mathias; Stolz, Lukas; Karam, Nicole; Praz, Fabien; Kalbacher, Daniel; Ludwig, Sebastian; Braun, Daniel; Näbauer, Michael; Wild, Mirjam G; Neuss, Michael; Butter, Christian; Kassar, Mohammad; Petrescu, Aniela; Pfister, Roman; Iliadis, Christos; Unterhuber, Matthias; Park, Sang-Don; Thiele, Holger; Baldus, Stephan; von Bardeleben, Stephan; Schofer, Niklas; Massberg, Steffen; Windecker, Stephan; Lurz, Philipp; Hausleiter, Jörg.
In: JACC-CARDIOVASC INTE, Vol. 14, No. 11, 14.06.2021, p. 1243-1253.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of Residual Mitral Regurgitation on Survival After Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation
AU - Higuchi, Satoshi
AU - Orban, Mathias
AU - Stolz, Lukas
AU - Karam, Nicole
AU - Praz, Fabien
AU - Kalbacher, Daniel
AU - Ludwig, Sebastian
AU - Braun, Daniel
AU - Näbauer, Michael
AU - Wild, Mirjam G
AU - Neuss, Michael
AU - Butter, Christian
AU - Kassar, Mohammad
AU - Petrescu, Aniela
AU - Pfister, Roman
AU - Iliadis, Christos
AU - Unterhuber, Matthias
AU - Park, Sang-Don
AU - Thiele, Holger
AU - Baldus, Stephan
AU - von Bardeleben, Stephan
AU - Schofer, Niklas
AU - Massberg, Steffen
AU - Windecker, Stephan
AU - Lurz, Philipp
AU - Hausleiter, Jörg
N1 - Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2021/6/14
Y1 - 2021/6/14
N2 - OBJECTIVES: The aim of this study was to assess the impact of residual mitral regurgitation (resMR) on mortality with respect to left ventricular dilatation (LV-Dil) or right ventricular dysfunction (RV-Dys) in patients with secondary mitral regurgitation (SMR) who underwent mitral valve transcatheter edge-to-edge repair (TEER).BACKGROUND: The presence of LV-Dil and RV-Dys correlates with advanced stages of heart failure in SMR patients, which may impact the outcome after TEER.METHODS: SMR patients in a European multicenter registry were evaluated. Investigated outcomes were 2-year all-cause mortality and improvement in New York Heart Association functional class with respect to MR reduction, LV-Dil (defined as LV end-diastolic volume ≥159 ml), and RV-Dys (defined as tricuspid annular plane systolic excursion-to-systolic pulmonary artery pressure ratio of <0.274 mm/mm Hg).RESULTS: Among 809 included patients, resMR ≤1+ was achieved in 546 (67%) patients. Overall estimated 2-year mortality rate was 32%. Post-procedural resMR was significantly associated with mortality (p = 0.031). Although the improvement in New York Heart Association functional class persisted regardless of either LV-Dil or RV-Dys, the beneficial treatment effect of resMR ≤1+ on 2-year mortality was observed only in patients without LV-Dil and RV-Dys (hazard ratio: 1.75; 95% confidence interval: 1.03 to 3.00).CONCLUSIONS: Achieving optimal MR reduction by TEER is associated with improved survival in SMR patients, especially if the progress in heart failure is not too advanced. In SMR patients with advanced stages of heart failure, as evidenced by LV-Dil or RV-Dys, the treatment effect of TEER on symptomatic improvement is maintained, but the survival benefit appears to be reduced.
AB - OBJECTIVES: The aim of this study was to assess the impact of residual mitral regurgitation (resMR) on mortality with respect to left ventricular dilatation (LV-Dil) or right ventricular dysfunction (RV-Dys) in patients with secondary mitral regurgitation (SMR) who underwent mitral valve transcatheter edge-to-edge repair (TEER).BACKGROUND: The presence of LV-Dil and RV-Dys correlates with advanced stages of heart failure in SMR patients, which may impact the outcome after TEER.METHODS: SMR patients in a European multicenter registry were evaluated. Investigated outcomes were 2-year all-cause mortality and improvement in New York Heart Association functional class with respect to MR reduction, LV-Dil (defined as LV end-diastolic volume ≥159 ml), and RV-Dys (defined as tricuspid annular plane systolic excursion-to-systolic pulmonary artery pressure ratio of <0.274 mm/mm Hg).RESULTS: Among 809 included patients, resMR ≤1+ was achieved in 546 (67%) patients. Overall estimated 2-year mortality rate was 32%. Post-procedural resMR was significantly associated with mortality (p = 0.031). Although the improvement in New York Heart Association functional class persisted regardless of either LV-Dil or RV-Dys, the beneficial treatment effect of resMR ≤1+ on 2-year mortality was observed only in patients without LV-Dil and RV-Dys (hazard ratio: 1.75; 95% confidence interval: 1.03 to 3.00).CONCLUSIONS: Achieving optimal MR reduction by TEER is associated with improved survival in SMR patients, especially if the progress in heart failure is not too advanced. In SMR patients with advanced stages of heart failure, as evidenced by LV-Dil or RV-Dys, the treatment effect of TEER on symptomatic improvement is maintained, but the survival benefit appears to be reduced.
U2 - 10.1016/j.jcin.2021.03.050
DO - 10.1016/j.jcin.2021.03.050
M3 - SCORING: Journal article
C2 - 33992551
VL - 14
SP - 1243
EP - 1253
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 11
ER -