Bibliographic Details
| Title: |
Evolution of tricuspid regurgitation after transcatheter edge‐to‐edge mitral valve repair for secondary mitral regurgitation and its impact on mortality. |
| Authors: |
Adamo, Marianna, Pagnesi, Matteo, Ghizzoni, Giulia, Estévez‐Loureiro, Rodrigo, Raposeiras‐Roubin, Sergio, Tomasoni, Daniela, Stolfo, Davide, Sinagra, Gianfranco, Popolo Rubbio, Antonio, Bedogni, Francesco, De Marco, Federico, Giannini, Cristina, Petronio, Anna Sonia, Stazzoni, Laura, Benito‐González, Tomás, Fernández‐Vázquez, Felipe, Garrote‐Coloma, Carmen, Godino, Cosmo, Agricola, Eustachio, Munafò, Andrea |
| Source: |
European Journal of Heart Failure; Nov2022, Vol. 24 Issue 11, p2175-2184, 10p, 5 Charts, 6 Graphs |
| Subject Terms: |
MITRAL valve, MITRAL valve insufficiency, SYSTOLIC blood pressure, LEFT heart atrium, PULMONARY artery |
| Abstract: |
Aim: To evaluate short‐term changes in tricuspid regurgitation (TR) after transcatheter edge‐to‐edge mitral valve repair (M‐TEER) in secondary mitral regurgitation (SMR), their predictors and impact on mortality. Methods and results: This is a retrospective analysis of SMR patients undergoing successful M‐TEER (post‐procedural mitral regurgitation ≤2+) at 13 European centres. Among 503 patients evaluated 79 (interquartile range [IQR] 40–152) days after M‐TEER, 173 (35%) showed ≥1 degree of TR improvement, 97 (19%) had worsening of TR, and 233 (46%) remained unchanged. Smaller baseline left atrial diameter and residual mitral regurgitation 0/1+ were independent predictors of TR ≤2+ after M‐TEER. There was a significant association between TR changes and New York Heart Association class and pulmonary artery systolic pressure decrease at echocardiographic re‐assessment. At a median follow‐up of 590 (IQR 209–1103) days from short‐term echocardiographic re‐assessment, all‐cause mortality was lower in patients with improved compared to those with unchanged/worsened TR (29.6% vs. 42.3% at 3 years; log‐rank p = 0.034). Baseline TR severity was not associated with mortality, whereas TR 0/1+ and 2+ at short‐term follow‐up was associated with lower all‐cause mortality compared to TR 3/4+ (30.6% and 35.6% vs. 55.6% at 3 years; p < 0.001). A TR ≤2+ after M‐TEER was independently associated with a 42% decreased risk of mortality (p = 0.011). Conclusion: More than one third of patients with SMR undergoing successful M‐TEER experienced an improvement in TR. Pre‐procedural TR was not associated with outcome, but a TR ≤2+ at short‐term follow‐up was independently associated with long‐term mortality. Optimal M‐TEER result and a small left atrium were associated with a higher likelihood of TR ≤2+ after M‐TEER. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
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