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May 24, 2026ESC Heart FailureOpen Access

M-TEER yields similar 36-month clinical improvement in patients with preserved versus reduced LVEF.

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Why the study?

M-TEER improves outcomes in secondary mitral regurgitation with reduced LVEF, but evidence in patients with preserved LVEF remains limited.

Does mitral transcatheter edge-to-edge repair improve clinical outcomes in patients with symptomatic secondary mitral regurgitation?

Population

93 consecutive patients with symptomatic SMR treated with M-TEER

Comparison

Stratified by LVEF (<50% vs ≥50%) and LAVI (<60 vs ≥60 mL/m2)

Design

Retrospective cohort study

Follow-up

36 months

Key result

Mitral transcatheter edge-to-edge repair yielded similar 36-month clinical improvement in patients with preserved versus reduced LVEF (62.5% vs 51.8%, p=0.32).

Authors

LRLouise RouleauMSMarina Petersen SaadiAWAdrien Al Wazzan

Discussion

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Overview

Similar improvement across LVEF after M-TEER is hypothesis-generating; leaves open randomized confirmation in preserved LVEF.

Key Points

  • This research aims to evaluate the impact of left ventricular function and atrial remodeling on clinical outcomes following mitral transcatheter edge-to-edge repair (M-TEER).
  • Retrospective analysis of 93 patients with symptomatic secondary mitral regurgitation treated with M-TEER from 2018 to 2022.
  • Patients were stratified based on left ventricular ejection fraction (LVEF) and left atrial volume index (LAVI).
  • Primary endpoint assessed was comprehensive clinical improvement at 36 months using Kaplan–Meier and Cox proportional hazards analyses.
  • 55% of patients achieved the composite endpoint of clinical improvement at 36 months.
  • All-cause mortality was lower in patients with preserved LVEF (9.4%) compared to reduced LVEF (29.6%).
  • Enlarged left atrial volume (LAVI ≥60 mL/m2) was linked to increased mortality, indicating a worse prognosis.

Study Design

Type

Cohort (n=93)

Structured PICO

Does mitral transcatheter edge-to-edge repair improve clinical outcomes in patients with symptomatic secondary mitral regurgitation?

P
Population
93 consecutive patients with symptomatic secondary mitral regurgitation (SMR)
I
Intervention
Mitral transcatheter edge-to-edge repair (M-TEER)
O
Outcome
Comprehensive clinical improvement at 36 months, defined as survival without heart-failure hospitalization, New York Heart Association (NYHA) class I–II, and Kansas City Cardiomyopathy Questionnaire (KCCQ) score >60composite

Main Result

Absolute Event Rate: 62.5% vs 51.8%

p-value: p=0.32

M-TEER provides sustained clinical benefit in symptomatic secondary mitral regurgitation across the LVEF spectrum, with left atrial enlargement identifying patients at higher mortality risk.

Cite This Study

Rouleau et al. (2026) conducted a cohort in Symptomatic secondary mitral regurgitation (n=93). Mitral transcatheter edge-to-edge repair (M-TEER) in preserved LVEF (≥50%) vs. M-TEER in reduced LVEF (<50%) was evaluated on Comprehensive clinical improvement at 36 months (survival without heart-failure hospitalization, NYHA class I–II, and KCCQ score >60) (p=0.32). Mitral transcatheter edge-to-edge repair yielded similar 36-month clinical improvement in patients with preserved versus reduced LVEF (62.5% vs 51.8%, p=0.32).

synapsesocial.com/papers/6a12969048a0ea166567376bhttps://doi.org/10.1093/eschf/xvag149
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