Worsening mitral regurgitation at one year post-M-TEER was associated with an increased risk of adverse clinical outcomes compared to stable MR (HR 2.02; 95% CI 1.26-3.23; p=0.003).
Cohort (n=1,865)
Yes
Does maintaining stable MR (≤ mild) at one year post-M-TEER improve clinical outcomes and cardiac reverse remodeling compared to worsening MR in patients who achieved mild MR at discharge?
Maintaining mild MR at one year after M-TEER is associated with significantly better cardiac reverse remodeling and a lower risk of adverse clinical outcomes compared to worsening MR.
Hazard Ratio: 2.02 (95% CI 1.26–3.23)
p-value: p=0.003
Abstract Aims Residual mitral regurgitation (MR) after mitral transcatheter edge-to-edge repair (M-TEER) is associated with adverse prognosis. However, the long-term clinical impact of MR persistence or progression has not been well stratified. We aimed to evaluate the proportion, clinical benefits, and prognostic value of maintaining mild MR one year after M-TEER. Methods and Results This multicenter registry-based analysis included 1,865 patients who achieved mild MR at discharge following M-TEER. At one year, patients were classified as having stable MR (≤ mild) or worsening MR (≥ moderate). The frequency of left atrial (LA) and left ventricular (LV) reverse remodeling and tricuspid regurgitation (TR) improvement were assessed from baseline to one year. Clinical endpoints—including all-cause mortality and heart failure hospitalization—were evaluated beyond one year after M-TEER up to two years. Worsening MR occurred in 28.4% of patients. Compared with the worsening MR group, the stable MR group demonstrated significantly more frequent LA and LV reverse remodeling (38.4% vs. 28.1%, and 44.7% vs. 31.1%, respectively; both p0.001). Improvement in TR (≥ grade 1) was also more prevalent in the stable MR group (32.4% vs. 20.6%, p0.001). Worsening MR was independently associated with increased risk of adverse clinical outcomes (hazard ratio: 2.02; 95% confidence interval: 1.26–3.23; p=0.003). Conclusions Maintaining MR within mild at one-year post-M-TEER is associated with favorable cardiac reverse remodeling and improved clinical prognosis. These findings underscore the importance of long-term MR surveillance and its implications for outcome optimization following M-TEER.
Kurita et al. (Fri,) conducted a cohort in Residual mitral regurgitation after mitral transcatheter edge-to-edge repair (n=1,865). Worsening mitral regurgitation (≥ moderate) at one year vs. Stable mitral regurgitation (≤ mild) at one year was evaluated on Adverse clinical outcomes (including all-cause mortality and heart failure hospitalization) (HR 2.02, 95% CI 1.26-3.23, p=0.003). Worsening mitral regurgitation at one year post-M-TEER was associated with an increased risk of adverse clinical outcomes compared to stable MR (HR 2.02; 95% CI 1.26-3.23; p=0.003).
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