Novel Right Ventricular Function Parameters can Identify Short-Term Nonresponders to Transcatheter Edge-to-Edge Repair for Mitral Regurgitation.
Details
Serval ID
serval:BIB_07F2CDF48FC7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Novel Right Ventricular Function Parameters can Identify Short-Term Nonresponders to Transcatheter Edge-to-Edge Repair for Mitral Regurgitation.
Journal
The American journal of cardiology
ISSN
1879-1913 (Electronic)
ISSN-L
0002-9149
Publication state
Published
Issued date
15/07/2025
Peer-reviewed
Oui
Volume
247
Pages
13-20
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Mitral regurgitation (MR) is a common valvular disease associated with poor prognosis. Percutaneous mitral valve repair (PMVR) combined with guideline-directed medical therapy has shown prognostic benefits, yet a substantial proportion of patients experience major adverse cardiovascular events (MACE), including death and heart failure hospitalization, within the first year. Identifying short-term nonresponders remains a clinical priority. This study evaluated the prognostic value of advanced right ventricular (RV) function parameters in predicting MACE following PMVR using the MitraClip system. A total of 60 consecutive patients with symptomatic severe MR undergoing PMVR were analyzed. Echocardiographic assessments were performed at baseline, postprocedure before discharge, and at 6-month follow-up. Parameters included tricuspid annular plane systolic excursion (TAPSE) normalized to pulmonary artery systolic pressure (TAPSE/PASP), right ventricular end-diastolic area (TAPSE/RVAD), and end-systolic area (TAPSE/RVAS), along with RV myocardial work indices. During the first year, 35% of patients experienced MACE. At baseline, those who developed MACE had significantly higher creatinine, troponin T, NT-proBNP levels, larger right heart dimensions, and lower TAPSE (all p <0.05), while other clinical, imaging, and procedural characteristics were similar. In multivariate analysis, TAPSE/PASP, TAPSE/RVAS, and TAPSE/RVAD were independent predictors of MACE (all p <0.05), with AUC values ranging from 0.80 to 0.85, indicating strong predictive capacity. Throughout follow-up, these indices remained significantly lower in patients with MACE, while RV myocardial work parameters had lower predictive accuracy (AUC<0.60). In conclusion, a comprehensive RV assessment, particularly TAPSE-based indices, can help identify patients at higher risk of adverse outcomes after PMVR, whereas RV myocardial work indices appear less reliable.
Keywords
Humans, Mitral Valve Insufficiency/surgery, Mitral Valve Insufficiency/physiopathology, Male, Female, Ventricular Function, Right/physiology, Aged, Cardiac Catheterization/methods, Echocardiography, Prognosis, Follow-Up Studies, Heart Valve Prosthesis Implantation/methods, Middle Aged, Aged, 80 and over, echocardiography, mitral valve transcatheter edge-to-edge repair (M-TEER), right ventricular function, risk stratification
Pubmed
Web of science
Create date
08/04/2025 9:11
Last modification date
23/05/2025 7:11