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
Author(s)
Mistrulli R., Storozhenko T., Iturriagagoitia A., Corradetti S., Viscusi M.M., Buytaert D., Mahendiran T., de Oliveira E.K., Addeo L., Barbato E., Spapen J., Bartunek J., Vanderheyden M., Van Camp G., Penicka M.
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
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
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