B-58 | "Meta-Analysis on the Predictive Role of Pulmonary Hypertension Severity in Transcatheter Mitral Valve Repair Outcomes"

Pulmonary hypertension (pHTN) is linked to higher morbidity and mortality after transcatheter mitral valve repair (TMVR), but its role on clinical outcomes remains undetermined. This study aims to assess the predictive role of pHTN severity in TMVR Outcomes. We searched PubMed, Scopus, and Google Scholar to identify studies reporting outcomes after TMVR in individuals with pHTN. Pooled odds ratios (OR) for 1-year all-cause mortality (ACM), major adverse cardiac and cerebrovascular events (MACCE), and recurrent hospitalizations in mild (mPAP <35), moderate (mPAP 35-50 mmHg) and severe pHTN (mPAP >50 mmHg) patients were calculated using a random-effects model. Heterogeneity were assesed using I2 and subgroup analyses were performed We included 4 studies with 5,332 patients. Mean age was 76.2 (±5.2) years, with 48.4% being male, and 91% New York Heart Association (NYHA) class III/IV. Severe pulmonary hypertension (pHTN) linked to higher 1-year ACM risk than moderate pHTN (OR: 1.4, CI: 1.13-1.69, p = 0.001) and mild pHTN (OR: 1.9, CI: 1.58-2.26, p < 0.0001) at median 360-day follow-up. Similarly, severe pHTN associated with elevated 1-year MACCE risk compared to moderate pHTN (OR: 1.4, CI: 1.12-1.66, p = 0.001) and mild pHTN (OR: 1.8, CI: 1.49-2.13, p < 0.0001). Increased 1-year rehospitalization risks observed in severe pHTN versus moderate pHTN (OR: 1.3, CI: 1.1-1.56, p = 0.002) and mild pHTN (OR: 1.9, CI: 1.65-2.27, p < 0.0001). Severe pHTN is associated with increased 1-year ACM, MACCE, and rehospitalizations compared to mild and moderate pHTN patients. Monitoring and managing severe pHTN patients is essential before TMVR.