Key result
Following transcatheter edge-to-edge repair, functional mitral regurgitation independently predicted higher 1-year rates of MACE compared to degenerative mitral regurgitation (HR 1.78; 95% CI 1.23-2.48; p=0.04).
Why the study?
Guidelines support transcatheter edge-to-edge repair for both primary and secondary mitral regurgitation, but comparing prognoses between degenerative and functional mitral regurgitation was needed.
Does transcatheter edge-to-edge repair (TEER) yield different outcomes in patients with functional mitral regurgitation compared to degenerative mitral regurgitation?
Cohort (n=208)
Does transcatheter edge-to-edge repair (TEER) yield different outcomes in patients with functional mitral regurgitation compared to degenerative mitral regurgitation?
Hazard Ratio: 1.78 (95% CI 1.23–2.48)
Absolute Event Rate: 41.2% vs 21.7%
p-value: p=0.04
Patients undergoing TEER for functional mitral regurgitation have significantly worse 1-year composite MACE outcomes compared to those with degenerative mitral regurgitation.
Current guidelines support the use of transcatheter edge-to-edge repair (TEER) for patients with both primary and secondary mitral regurgitation. We aimed to compare the prognoses of TEER in degenerative mitral regurgitation (DMR) vs. functional mitral regurgitation (FMR). A total of 208 consecutive patients who underwent TEER over a ten-year period were analyzed. Primary endpoints included rates of all-cause death and major adverse cardiac events (MACE: composite of all-cause death, hospitalizations for heart failure, mitral valve surgery, or TEER re-intervention). A total of 148 (71%) patients were identified with FMR, while 60 (29%) were identified with DMR. Patients in the FMR group were younger (77.2 ± 8.4 vs. 80.2 ± 7.2, p = 0.02), suffered more frequently from coronary artery disease (54.1% vs. 10.0%, p = 0.02), and atrial fibrillation/flutter (70.9% vs. 38.3%, p = 0.02). Rates of 1-year death (21.6% vs. 10.0%, p = 0.03) and MACE (41.2% vs. 21.7%, p = 0.02) were higher for the FMR group, as compared to the DMR group. After correcting for variables, FMR independently predicted rates of MACE (HR-1.78, 95% CI 1.23–2.48, p = 0.04) and had a non-significant effect on one-year mortality (HR-1.67, 95%CI 0.98–3.74, p = 0.07). In our experience, worse overall 1-year composite MACE outcomes were observed after TEER in patients with FMR as compared to patients with DMR.
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Kheifets et al. (2022) conducted a cohort in Mitral Regurgitation (n=208). Functional mitral regurgitation (FMR) vs. Degenerative mitral regurgitation (DMR) was evaluated on Major adverse cardiac events (MACE: composite of all-cause death, hospitalizations for heart failure, mitral valve surgery, or TEER re-intervention) (HR 1.78, 95% CI 1.23-2.48, p=0.04). Following transcatheter edge-to-edge repair, functional mitral regurgitation independently predicted higher 1-year rates of MACE compared to degenerative mitral regurgitation (HR 1.78; 95% CI 1.23-2.48; p=0.04).
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