Key result
TEER in cardiogenic shock is linked to a ~32% higher cardiac index and reduced LA pressure.
Why the study?
Haemodynamic changes following mitral valve transcatheter edge-to-edge repair (TEER) in patients with cardiogenic shock and high-grade mitral regurgitation have not been thoroughly investigated.
Does transcatheter edge-to-edge repair improve haemodynamic parameters in patients with cardiogenic shock and high-grade mitral regurgitation?
Observational (n=25)
Does transcatheter edge-to-edge repair improve haemodynamic parameters in patients with cardiogenic shock and high-grade mitral regurgitation?
p-value: p=<0.01
TEER provides favorable hemodynamic stabilization, including reduced left atrial pressure and increased cardiac index, in patients with cardiogenic shock and high-grade mitral regurgitation without worsening left ventricular function.
May support hemodynamic stabilization with TEER in cardiogenic shock; hypothesis-generating and requires randomized confirmation.
Background Transcatheter edge-to-edge repair (TEER) has been shown to be an effective treatment option for patients experiencing cardiogenic shock (CS) with concomitant high-grade mitral valve regurgitation. However, haemodynamic changes following M-TEER have not been thoroughly investigated. Afterload mismatch, leading to the deterioration of haemodynamics subsequent to mitral regurgitation correction, could potentially occur and adversely impact prognosis. Our objective was to analyse the effect of TEER on haemodynamic and echocardiographic parameters in patients with CS. Methods and results We conducted a retrospective study of patients undergoing TEER for mitral valve regurgitation in the setting of CS. Haemodynamic and echocardiographic parameters before and after TEER were systematically analysed. A total of 25 patients underwent TEER in the context of CS. All patients were successfully treated with at least of one grade reduction in mitral regurgitation. The median left atrial mean pressure decreased from 23 mmHg (IQR 17–30) to 16 mmHg (IQR 11–20, P < 0.01), and the V-wave decreased from 36 mmHg (IQR 27–44) to 21 mmHg (IQR 14–25, P < 0.01) following the procedure. The stroke volume index and cardiac index increased from 25 mL/m2 (IQR 18–29) to 34 mL/m2 (IQR 25–44, P < 0.01) and from 1.90 L/min/m2 (IQR 1.41–2.30) to 2.50 L/min/m2 (IQR 1.99–2.86, P < 0.01), respectively. We did not observe any worsening of the ejection fraction after the procedure. Ten patients (40%) died during their hospital stay. Conclusions Our study demonstrates that TEER leads to favourable haemodynamic changes in patients with CS. We observed a significant reduction in left atrial pressure, V-wave, and an elevation in cardiac index. Importantly, we did not observe any deterioration in left ventricular function following the procedure. This supports the concept of haemodynamic stabilization with TEER in patients with CS and high-grade mitral regurgitation.
No takes yet. Share an insight, caveat, or question.
Droppa et al. (2025) conducted an observational in Cardiogenic shock with concomitant high-grade mitral valve regurgitation (n=25). Transcatheter edge-to-edge repair (TEER) was evaluated on Haemodynamic and echocardiographic parameters (p=<0.01). Transcatheter edge-to-edge repair in cardiogenic shock significantly reduced median left atrial mean pressure (23 to 16 mmHg, P<0.01) and increased cardiac index (1.90 to 2.50 L/min/m2, P<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: