Key result
Pulmonary disease is not linked to increased all-cause mortality after M-TEER.
Why the study?
Pulmonary diseases are frequently associated with impaired cardiac function and mitral and tricuspid regurgitation, but their impact on outcomes after mitral transcatheter edge-to-edge repair is unclear.
Does the presence of pulmonary disease worsen all-cause mortality in patients undergoing mitral transcatheter edge-to-edge repair?
Cohort (n=3,666)
Does the presence of pulmonary disease worsen all-cause mortality in patients undergoing mitral transcatheter edge-to-edge repair?
The presence of pulmonary disease does not significantly worsen intermediate-term all-cause mortality or heart failure hospitalization in patients undergoing mitral transcatheter edge-to-edge repair.
Answers are grounded in this paper and cite their sources.
M-TEER yields comparable intermediate-term survival regardless of pulmonary disease; leaves open optimal tricuspid regurgitation management in this population.
BACKGROUND: Pulmonary diseases (PD) are frequently associated with impaired cardiac function and the presence of mitral and tricuspid regurgitation (MR and TR). OBJECTIVES: The study aimed to clarify the impact of PD on clinical outcomes following mitral transcatheter edge-to-edge repair (M-TEER). METHODS: Of the 3,764 patients who underwent M-TEER, 3,666 were included in the analysis and stratified according to the absence or presence of PD before the procedure. The primary endpoint was all-cause mortality, evaluated using Kaplan-Meier analysis. Cardiovascular and non-cardiovascular mortality and HFH (HFH) were also assessed during a 4-year follow-up. Moreover, the prognostic impact of TR improvement after M-TEER was evaluated in patients with and without PD. RESULTS: Of the 3,666 patients, 580 (15.8%) had PD, included fewer women, and exhibited greater frailty compared with those without PD. Within a median follow-up of 432 [314-826] days, all-cause mortality did not differ significantly between patients with PD and those without (150 [25.9%] vs. 682 [22.1%], Log rank P = 0.331). No significant differences were observed in the incidence of cardiovascular mortality, non-cardiovascular mortality, and HFH between the two groups. When stratified by PD status, residual significant TR after M-TEER was significantly associated with HFH both in patients with PD and without PD. CONCLUSIONS: The intermediate-term prognosis after M-TEER was comparable between patients with and without PD. In patients with PD, MR was effectively reduced through minimally invasive M-TEER. However, appropriate management of TR after MTEER may be required to improve outcomes in this population. CLINICAL TRIALS: OCEAN-Mitral registry (UMIN-ID: UMIN000023653).
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Iwata et al. (2025) conducted a cohort in Mitral and tricuspid regurgitation requiring M-TEER (n=3,666). Pulmonary disease vs. Absence of pulmonary disease was evaluated on All-cause mortality (p=0.331). Pulmonary disease was not significantly associated with increased all-cause mortality compared to no pulmonary disease in patients undergoing M-TEER (25.9% vs 22.1%; P=0.331).
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