Tricuspid regurgitation improvement occurred frequently after transcatheter mitral valve repair and was associated with a reduced risk of heart failure hospitalization (HR 0.60).
Observational (n=531)
Yes
Does transcatheter mitral valve repair (TMVR) via the MitraClip improve tricuspid regurgitation in patients undergoing the procedure?
Tricuspid regurgitation improvement is frequent after transcatheter mitral valve repair, occurs early, and is associated with reduced heart failure hospitalizations.
Effect estimate: HR 0.60 (95% CI 0.38-0.94)
Absolute Event Rate: 27% vs 37%
p-value: p=0.025
BACKGROUND: Mitral valve repair may lead to alterations of tricuspid regurgitation (TR). AIMS: We aimed to investigate alterations, predictors and prognostic relevance of TR evolution in a large-scale multicentre population of patients undergoing transcatheter mitral valve repair (TMVR) via the MitraClip. METHODS: In total, we included 531 TMVR patients with at least one available follow-up echocardiography. TR improvement was defined as a TR ≥II at baseline, which showed a decline of at least one TR categorisation. RESULTS: Distribution of preprocedural TR severity was TR 0/I 41% (220/531), TR II 39% (209/531) and TR ≥III 19% (102/531), respectively. Follow-up echocardiography was at 308±187 days. TR severity improved to TR 0/I 49% (259/531), TR II 35% (183/531) and TR III 17% (89/531), p=0.003. Out of 311 patients with TR ≥II at baseline, 41% (127/311) showed TR improvement. Atrial fibrillation (AF), residual mitral regurgitation ≥II (rMR) and tricuspid annular diameter (TAD) remained variables which prevented TR improvement (odds ratio 0.49 0.29-0.84, 0.47 0.27-0.81 and 0.97 0.93-0.997, respectively). TR improvement was associated with better event-free survival regarding post-procedural heart failure hospitalisation (HHF) (hazard ratio 0.6 0.38-0.94). The main changes of TR severity occurred within 3 months post TMVR (p=0.006), while there were only minor TR changes between 3 and 12 months of follow-up (p=0.813). CONCLUSIONS: TR improvement was frequent after TMVR. Predictors preventing TR improvement were AF, post-procedural rMR, and TAD. Furthermore, TR improvement was an early phenomenon occurring primarily within the first three months post TMVR and served as a suitable marker of reduced HHF.
Kavsur et al. (Mon,) conducted a observational in Mitral regurgitation (n=531). Transcatheter mitral valve repair (TMVR) via MitraClip vs. Patients without tricuspid regurgitation improvement was evaluated on Heart failure hospitalization (HR 0.60, 95% CI 0.38-0.94, p=0.025). Tricuspid regurgitation improvement occurred frequently after transcatheter mitral valve repair and was associated with a reduced risk of heart failure hospitalization (HR 0.60).