Key result
Successful mitral regurgitation reduction (≤2+) during M-TEER produced a sustained 24% ± 11% increase in pulse contour analysis-derived cardiac output (p = 0.049).
Why the study?
Perioperative hemodynamic response patterns during M-TEER using pulse contour analysis and the determinants of heterogeneous cardiac output responses following mitral regurgitation reduction needed characterization.
Does mitral transcatheter edge-to-edge repair improve pulse contour analysis-derived cardiac output in patients with mitral regurgitation?
Observational (n=16)
No
Does mitral transcatheter edge-to-edge repair improve pulse contour analysis-derived cardiac output in patients with mitral regurgitation?
Answers are grounded in this paper and cite their sources.
Continuous pulse contour analysis reveals that early cardiac output improvement after mitral transcatheter edge-to-edge repair is not universal, depending instead on effective mitral regurgitation reduction and baseline left ventricular functional reserve.
Objectives To characterize perioperative hemodynamic response patterns during transcatheter edge-to-edge mitral valve repair (M-TEER) using pulse contour analysis (PCA), and to identify determinants of heterogeneous cardiac output responses following mitral regurgitation (MR) reduction. Design Prospective, single-center observational study. Setting Single tertiary academic medical center. Participants Sixteen consecutive patients undergoing M-TEER with the PASCAL Ace system (Edwards Lifesciences). Interventions Continuous PCA monitoring was performed from baseline until 4 h postprocedural alongside periprocedural echocardiography. The primary endpoint was the change in PCA-derived cardiac output (PCA-CO). Secondary endpoints assessed associations between hemodynamic response, procedural success, and ventricular function. Measurements and Main Results Hemodynamic responses varied according to MR reduction and ventricular function. Sustained PCA-CO improvement occurred only with successful MR reduction (≤2+; 24% ± 11%; p = 0.049). Patients with reduced left ventricular ejection fraction showed an early, transient increase in PCA-CO, reaching 108% of baseline (IQR, 86–136%) after first-device implantation (Dunn-adjusted p = 0.035), which was no longer evident at 4 h (p = 0.80). In contrast, patients with preserved ejection fraction showed a delayed, sustained increase at 4 h (14% ± 13%; p = 0.035). Patients with a left ventricular end-diastolic diameter <60 mm also showed increased PCA-CO at 4 h (12% ± 18%; p = 0.049). Changes in PCA-CO correlated inversely with systolic pulmonary artery pressure (ρ = −0.60; p = 0.026), while left atrial v-wave amplitude decreased significantly (p < 0.001). Conclusions Early hemodynamic changes after M-TEER is not universal but depends on effective MR reduction and ventricular functional reserve. Continuous PCA identified distinct response patterns despite technically successful valve repair.
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Uhle et al. (2026) conducted an observational in Mitral regurgitation (n=16). Transcatheter edge-to-edge mitral valve repair (M-TEER) monitored with continuous pulse contour analysis vs. Baseline and subgroups stratified by MR reduction and left ventricular function was evaluated on Change in pulse contour analysis-derived cardiac output (PCA-CO) (p=0.049). Successful mitral regurgitation reduction (≤2+) during M-TEER produced a sustained 24% ± 11% increase in pulse contour analysis-derived cardiac output (p = 0.049).
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