Why the study?
Patient selection for TEER in primary mitral regurgitation does not systematically assess associated cardiac remodelling, and the prognostic impact of extra-mitral valve cardiac involvement remains unclear.
Does extra-mitral valve cardiac involvement predict all-cause death in patients with primary mitral regurgitation undergoing transcatheter edge-to-edge repair?
Does extra-mitral valve cardiac involvement predict all-cause death in patients with primary mitral regurgitation undergoing transcatheter edge-to-edge repair?
Extra-mitral valve cardiac involvement is an independent predictor of midterm mortality in patients with primary mitral regurgitation undergoing transcatheter edge-to-edge repair, suggesting its utility in risk stratification.
Extra-MV involvement independently predicted higher 2-year mortality after TEER in PMR; supports refined phenotyping for risk stratification but leaves practice change open.
BACKGROUND: In the context of primary mitral regurgitation (PMR), the selection of patients for transcatheter edge-to-edge repair (TEER) does not include a systematic assessment of PMR-associated cardiac remodelling. AIMS: We aimed to investigate the epidemiology and prognostic significance of different phenotypes of extra-mitral valve (MV) cardiac involvement in a large series of patients with PMR referred for TEER. METHODS: The study included 654 patients from the multicentre Italian GIOTTO registry, stratified into groups according to extra-mitral valve (MV) cardiac involvement. The primary endpoint was all-cause death at 2-year follow-up. RESULTS: Patients with no cardiac involvement (NI; n=58), left heart involvement (LHI; n=343) and right heart involvement (RHI; n=253) were analysed. Acute technical success was achieved in 98% of patients. Kaplan-Meier curve analysis revealed significantly worse survival in patients with LHI and RHI (p=0.041). On multivariate Cox regression analysis, extra-MV cardiac involvement, haemoglobin level and technical success were independent predictors of the primary endpoint occurrence. CONCLUSIONS: Grading cardiac involvement may help refine risk stratification, since at least 1 group of extra-MV cardiac involvement represents in itself a negative predictor of midterm outcome.
No takes yet. Share an insight, caveat, or question.
Rubbio et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: