Echocardiography (Mount Kisco, N.Y.) · 2026
Right Ventricular-Pulmonary Artery Coupling and Clinical Outcomes Following Mitral Transcatheter Edge-to-Edge Repair: A Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Theofilis Panagiotis, Sakalidis Athanasios, Karakasis Paschalis, Vlachakis Panayotis K, Oikonomou Evangelos, Mantzouranis Emmanouil, Iliakis Panagiotis, Dimitriadis Kyriakos, Pantelidis Panteleimon, Pamporis Konstantinos, Aggeli Konstantina, Tsioufis Konstantinos, Tousoulis Dimitris
Аннотация
BACKGROUND: Right ventricular-pulmonary artery (RVPA) coupling is an emerging prognostic marker in cardiovascular disease, but its predictive value in patients undergoing mitral transcatheter edge-to-edge repair (MTEER) remains uncertain.
METHODS: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched for studies evaluating the prognostic impact of RVPA coupling in patients undergoing MTEER, using tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) or related markers. Risk of bias was assessed with the ROBINS-I tool, and meta-analyses were used to evaluate associations with clinical outcomes, including all-cause mortality, major adverse cardiovascular events (MACE), and residual mitral regurgitation (MR).
RESULTS: Nine studies involving 3281 patients were included. Baseline RVPA uncoupling was significantly associated with an increased incidence of MACE (risk ratio [RR] 1.75, 95% confidence interval [CI]: 1.40-2.19) and higher all-cause mortality (RR 1.82, 95% CI: 1.53-2.18). No significant association was observed with post-operative MR (RR 1.17, 95% CI: 0.83-1.63). Sensitivity analyses did not alter the direction of the findings.
CONCLUSION: RVPA uncoupling is associated with adverse outcomes after MTEER. Routine assessment may improve pre-procedural risk stratification. Further studies should refine diagnostic thresholds and evaluate potential therapeutic strategies in the setting of impaired RVPA coupling prior to MTEER.
METHODS: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched for studies evaluating the prognostic impact of RVPA coupling in patients undergoing MTEER, using tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) or related markers. Risk of bias was assessed with the ROBINS-I tool, and meta-analyses were used to evaluate associations with clinical outcomes, including all-cause mortality, major adverse cardiovascular events (MACE), and residual mitral regurgitation (MR).
RESULTS: Nine studies involving 3281 patients were included. Baseline RVPA uncoupling was significantly associated with an increased incidence of MACE (risk ratio [RR] 1.75, 95% confidence interval [CI]: 1.40-2.19) and higher all-cause mortality (RR 1.82, 95% CI: 1.53-2.18). No significant association was observed with post-operative MR (RR 1.17, 95% CI: 0.83-1.63). Sensitivity analyses did not alter the direction of the findings.
CONCLUSION: RVPA uncoupling is associated with adverse outcomes after MTEER. Routine assessment may improve pre-procedural risk stratification. Further studies should refine diagnostic thresholds and evaluate potential therapeutic strategies in the setting of impaired RVPA coupling prior to MTEER.