Transcatheter edge-to-edge repair significantly improved LV ejection fraction by 1.51% and reduced LV volumes and diameters, RV function improved, and pulmonary pressure dropped by 6.75 mm Hg.
Does transcatheter edge-to-edge repair improve echocardiographic indices of cardiac remodeling in patients with secondary mitral regurgitation?
TEER promotes significant favorable cardiac remodeling, including improvements in LV volumes, LVEF, and right ventricular function, in patients with secondary mitral regurgitation.
Absolute Event Rate: 0% vs 0%
Background Secondary mitral regurgitation is associated with adverse clinical outcomes and cardiac remodeling. While transcatheter edge‐to‐edge repair (TEER) improves symptoms and prognosis in selected patients, its effects on cardiac remodeling remain debated. This systematic review and meta‐analysis aimed to evaluate the impact of TEER on echocardiographic indices of cardiac remodeling. Methods PubMed, Scopus, and Cochrane Library were used to identify relevant studies assessing echocardiographic changes before and after TEER. Outcomes of interest were left ventricular (LV) ejection fraction, global longitudinal strain, LV end‐diastolic and end‐systolic volumes and LV end‐diastolic and end‐systolic diameter, tricuspid annular plane systolic excursion, pulmonary artery systolic pressure, and left atrial end‐systolic volume. Results Forty‐two studies (3987 patients) were included. TEER was associated with a significant increase in LV ejection fraction (mean difference MD, 1.51% 95% CI, 0.47–2.55), without significant improvement in global longitudinal strain. Significant LV remodeling was observed, with reductions in LV end‐diastolic volume (standardized MD, −0.26 95% CI, −0.37 to −0.14), LV end‐systolic volume (standardized MD, −0.21 95% CI, −0.30 to −0.12), LV end‐diastolic diameter (MD, −2.35 mm 95% CI, −3.66 to −1.04) and left ventricular end‐systolic diameter (MD, −2.30 mm 95% CI, −3.86 to −0.74). TEER also improved right ventricular function (tricuspid annular plane systolic excursion [MD, 1.29 mm [95% CI, 0.60–1.97) and reduced pulmonary artery systolic pressure (MD, −6.75 mm Hg [95% CI, −8.53 to −4.97). No significant improvement in left atrial end‐systolic volume was detected. Conclusions Available evidence suggests that TEER promotes significant cardiac remodeling in patients with secondary mitral regurgitation.
Lombardi et al. (Wed,) reported a other. Transcatheter edge-to-edge repair significantly improved LV ejection fraction by 1.51% and reduced LV volumes and diameters, RV function improved, and pulmonary pressure dropped by 6.75 mm Hg.