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Войти в исследования ESC heart failure · 2026
Impact of maintaining mild mitral regurgitation beyond 1 year after mitral transcatheter edge-to-edge repair.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Kurita Azusa, Yamamoto Masanori, Shimura Tetsuro, Kagase Ai, Tokuda Takahiro, Sugiura Atsushi, Tsunamoto Hiroshi, Yamaguchi Ryo, Saji Mike, Izumi Yuki, Asami Masahiko, Enta Yusuke, Hachinohe Daisuke, Shirai Shinichi, Izumo Masaki, Mizuno Shingo, Watanabe Yusuke, Amaki Makoto, Kodama Kazuhisa, Otsuki Hisao, Naganuma Toru, Bota Hiroki, Ohno Yohei, Yamawaki Masahiro, Ueno Hiroshi, Nakazawa Gaku, Otsuka Toshiaki, Kubo Shunsuke, Hayashida Kentaro
Аннотация
INTRODUCTION: Residual mitral regurgitation (MR) after mitral transcatheter edge-to-edge repair (M-TEER) is associated with adverse prognosis. However, the long-term clinical impact of MR persistence or progression has not been well stratified. We aimed to evaluate the proportion, clinical benefits, and prognostic value of maintaining mild MR 1 year after M-TEER.
METHODS AND RESULTS: This multi-centre registry-based analysis included 1865 patients who achieved mild MR at discharge following M-TEER. At 1 year, patients were classified as having stable MR (≤ mild) or worsening MR (≥ moderate). The frequency of left atrial (LA) and left ventricular (LV) reverse remodelling and tricuspid regurgitation (TR) improvement were assessed from baseline to 1 year. Clinical endpoints-including all-cause mortality and heart failure hospitalization-were evaluated beyond 1 year after M-TEER up to 2 years. Worsening MR occurred in 28.4% of patients. Compared with the worsening MR group, the stable MR group demonstrated significantly more frequent LA and LV reverse remodelling (38.4% vs 28.1%, and 44.7% vs 31.1%, respectively; both P < .001). Improvement in TR (≥ Grade 1) was also more prevalent in the stable MR group (32.4% vs 20.6%, P < .001). Worsening MR was independently associated with increased risk of adverse clinical outcomes (hazard ratio: 2.02; 95% confidence interval: 1.26-3.23; P = .003).
CONCLUSION: Maintaining MR within mild at 1-year post-M-TEER is associated with favourable cardiac reverse remodelling and improved clinical prognosis. These findings underscore the importance of long-term MR surveillance and its implications for outcome optimization following M-TEER.
METHODS AND RESULTS: This multi-centre registry-based analysis included 1865 patients who achieved mild MR at discharge following M-TEER. At 1 year, patients were classified as having stable MR (≤ mild) or worsening MR (≥ moderate). The frequency of left atrial (LA) and left ventricular (LV) reverse remodelling and tricuspid regurgitation (TR) improvement were assessed from baseline to 1 year. Clinical endpoints-including all-cause mortality and heart failure hospitalization-were evaluated beyond 1 year after M-TEER up to 2 years. Worsening MR occurred in 28.4% of patients. Compared with the worsening MR group, the stable MR group demonstrated significantly more frequent LA and LV reverse remodelling (38.4% vs 28.1%, and 44.7% vs 31.1%, respectively; both P < .001). Improvement in TR (≥ Grade 1) was also more prevalent in the stable MR group (32.4% vs 20.6%, P < .001). Worsening MR was independently associated with increased risk of adverse clinical outcomes (hazard ratio: 2.02; 95% confidence interval: 1.26-3.23; P = .003).
CONCLUSION: Maintaining MR within mild at 1-year post-M-TEER is associated with favourable cardiac reverse remodelling and improved clinical prognosis. These findings underscore the importance of long-term MR surveillance and its implications for outcome optimization following M-TEER.