Mitral Transcatheter Edge-to-Edge Repair and Clinical Value of Novel Echocardiographic Biomarkers: A Hypothesis-Generating Study

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2024 Aug 29

PMID 39200177

Authors

Javier Solsona-Caravaca

Ruben Fernandez-Galera

Victor Gonzalez-Fernandez

Lorenzo Airale

Johny Rivas

Luca Scudeler

Nuria Vallejo

Gisela Teixido-Tura

Guillem Casas

Filipa Valente

Ruper Olivero

Yassin Belahnech

Gerard Marti

Bruno Garcia

Ignacio Ferreira-Gonzalez

Jose F Rodriguez-Palomares

Laura Galian-Gay

Affiliations

Soon will be listed here.

Abstract

Background: Longitudinal data on reverse cardiac remodeling and outcomes after transcatheter edge-to-edge repair (TEER) are limited.

Methods: A total of 78 patients with severe mitral regurgitation (MR) were included retrospectively. All patients had echocardiography at baseline and again six months after TEER. They were monitored for a primary composite endpoint, consisting of heart failure hospitalization and cardiovascular death, over 13 months.

Results: Significant decreases in the left ventricular ejection fraction (LVEF), all myocardial work indices (except global wasted work), and the left atrial reservoir were observed after TEER. Additionally, there was a decrease in the pulmonary artery systolic pressure and an increase in the tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) ratio. A post-TEER TAPSE/PASP ratio of <0.47 (HR: 4.76, -value = 0.039), and a post-TEER left atrial reservoir of <9.0% (HR: 2.77, -value = 0.047) were associated with the primary endpoint.

Conclusions: Echocardiography post-TEER reflects impairment in ventricular performance due to preload reduction and right ventricle and pulmonary artery coupling improvement. Short-term echocardiography after TEER identifies high-risk patients who could benefit from a close clinical follow-up. The prognostic significance of LA strain and the TAPSE/PASP ratio should be validated in subsequent large-scale prospective studies.

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