Transcatheter aortic valve replacement was associated with functional mitral regurgitation improvement in 53.2% (59 of 111) of patients with pure severe aortic regurgitation at 1 month.
Cohort (n=111)
No
What are the predictors of functional mitral regurgitation improvement in patients with pure severe aortic regurgitation undergoing TAVR?
Approximately half of patients with pure severe aortic regurgitation and concomitant functional mitral regurgitation experience FMR improvement 1 month after TAVR, with higher baseline FMR, lower LVEF, and hypertension predicting improvement.
Background: Transcatheter aortic valve replacement (TAVR) is now recognized as an important treatment for pure severe aortic regurgitation (PSAR). Some patients with PSAR also suffer from functional mitral regurgitation (FMR). However, whether TAVR can improve FMR in patients with PSAR and the predictors of this improvement remain unknown. Thus, this study aimed to explore predictors of FMR improvement in patients with PSAR undergoing TAVR. Methods: Patients with PSAR and ≥mild FMR who underwent TAVR at the Zhongshan Hospital Affiliated with Fudan University were enrolled from June 2020 to June 2024. Participants were divided into groups with or without FMR improvement depending on whether FMR improved 1 month post-TAVR. Baseline data, imaging results, and follow-up data of the patients were collected. Result: This study included 111 patients, among whom 59 had improved FMR, and 52 did not. Compared to patients without FMR improvement, significantly fewer patients in the FMR-improved group were diagnosed with renal insufficiency (0% vs. 10%; p = 0.015) and left bundle branch block (0% vs. 8%; p = 0.030). Moreover, more were diagnosed with hypertension (80% vs. 56%; p = 0.007), and right bundle branch block (10% vs. 0%; p = 0.018). On transthoracic ultrasound, patients with FMR improvement were more likely to have a lower left ventricular ejection fraction (LVEF) and larger left ventricular end-diastolic (LVED) dimensions. In both groups, the degree of aortic regurgitation was significantly improved during 1-day and 1-month follow-ups post-TAVR (p < 0.001). No significant differences in the incidence of postoperative adverse events were found between the two groups during the short-term follow-up. Patients with higher degrees of FMR, lower LVEF, and hypertension were more likely to experience improvement in FMR post-TAVR. Conclusion: FMR improvement is observed in approximately half of PSAR patients undergoing TAVR. Higher FMR, lower LVEF, and hypertension before a TAVR are independent predictors of improvement in FMR.
Lin et al. (Mon,) conducted a cohort in Pure severe aortic regurgitation and ≥mild functional mitral regurgitation (n=111). TAVR was evaluated on FMR improvement 1 month post-TAVR. Transcatheter aortic valve replacement was associated with functional mitral regurgitation improvement in 53.2% (59 of 111) of patients with pure severe aortic regurgitation at 1 month.