A post-procedural mitral valve sphericity index >0.86 increased the risk of all-cause mortality and heart failure hospitalization (HR 2.35) after transcatheter edge-to-edge repair.
Observational (n=99)
No
Does a post-procedural mitral valve sphericity index >0.86 increase the risk of all-cause mortality and heart failure hospitalization in patients with functional mitral regurgitation undergoing MV-TEER?
A more circular mitral valve morphology (sphericity index >0.86) after transcatheter edge-to-edge repair for functional mitral regurgitation is associated with a more than two-fold increased risk of mid-term mortality and heart failure hospitalization.
Effect estimate: HR 2.35 (95% CI 1.25-4.42)
Absolute Event Rate: 63.6% vs 36.4%
p-value: p=0.0077
BACKGROUND: Changes in mitral valve (MV) morphology during MV transcatheter edge-to-edge repair (MV-TEER) are associated with short-term reduction of mitral regurgitation (MR). However, whether these changes are associated with prognosis remains unclear. Using 3-dimensional transesophageal echocardiography, this study evaluated the impact of MV morphological parameters on the mid-term prognosis of patients with functional MR (FMR). METHODS AND RESULTS: We analyzed 99 patients with FMR who were treated with MV-TEER. The primary endpoint was a composite of all-cause mortality and hospitalization due to heart failure. Patients were divided into 2 groups based on the post-procedural sphericity index of the mitral valve (SI-MV), which is the ratio of the vertical to horizontal MV diameter. Using receiver operating characteristic curve (ROC) analysis for the primary endpoint, the SI-MV cut-off value was determined to be 0.86. The incidence of the primary endpoint was significantly (log-rank P=0.013) higher among patients with a post-procedural SI-MV >0.86 (circular MV morphology) than among those with post-procedural SI-MV ≤0.86 (elliptical MV morphology). Post-procedural SI-MV >0.86 was an independent determinant of the primary endpoint in multivariate analysis (hazard ratio 2.35; 95% confidence interval 1.25-4.42; P=0.0077). CONCLUSIONS: A larger post-procedural SI-MV is associated with increased mid-term adverse clinical events after MV-TEER in patients with FMR.
Kawamoto et al. (Fri,) conducted a observational in Functional mitral regurgitation (n=99). Post-procedural sphericity index of the mitral valve >0.86 vs. Post-procedural sphericity index of the mitral valve ≤0.86 was evaluated on Composite of all-cause mortality and hospitalization due to heart failure (HR 2.35, 95% CI 1.25-4.42, p=0.0077). A post-procedural mitral valve sphericity index >0.86 increased the risk of all-cause mortality and heart failure hospitalization (HR 2.35) after transcatheter edge-to-edge repair.