International journal of cardiology · 2026
Changes in right ventricular-pulmonary artery coupling after transcatheter edge-to-edge repair in primary and atrial mitral regurgitation.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Paulus Michael, Suloja Nure, Grewe Franziska, Haus Moritz, Bienert Valeska, Wester Michael, Schach Christian, Luchner Andreas, Birner Christoph, Unsöld Bernhard, Maier Lars S, Debl Kurt, Meindl Christine
Аннотация
BACKGROUND: Right ventricular-pulmonary artery (RV-PA) coupling is an established marker of prognosis in mitral regurgitation (MR), but data on its change after transcatheter edge-to-edge mitral valve repair (M-TEER) in primary or atrial MR are limited.
METHODS: RV-PA coupling was evaluated in 190 patients undergoing M-TEER for primary or atrial MR before and one month after the procedure. RV-PA coupling was assessed using the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). The primary endpoint was the composite of death or hospitalization for heart failure during follow-up.
RESULTS: One month after M-TEER, RV-PA coupling improved in 78 patients (41.1%), driven by both improved RV systolic function (ΔTAPSE 2.2 ± 4.4 mm) and lower PASP (ΔPASP -14.7 ± 11.9 mmHg). Improvement in TAPSE/PASP was associated with less residual MR and better functional status after the procedure, but not with a lower risk of death or heart failure hospitalization during follow-up. In contrast, preserved RV-PA coupling at one month after M-TEER, defined as TAPSE/PASP >0.33 mm/mmHg, identified a subgroup at lower risk of the primary endpoint (hazard ratio 0.46 [95% confidence interval 0.26-0.81], p = 0.008).
CONCLUSION: M-TEER is associated with improvement in RV-PA coupling in patients with primary or atrial MR. Persistent RV-PA uncoupling identifies a high-risk group for adverse events after the procedure. Future studies in dedicated aetiology-specific cohorts are required to establish the role of serial RV-PA coupling assessment in post-procedural risk stratification after M-TEER.
METHODS: RV-PA coupling was evaluated in 190 patients undergoing M-TEER for primary or atrial MR before and one month after the procedure. RV-PA coupling was assessed using the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). The primary endpoint was the composite of death or hospitalization for heart failure during follow-up.
RESULTS: One month after M-TEER, RV-PA coupling improved in 78 patients (41.1%), driven by both improved RV systolic function (ΔTAPSE 2.2 ± 4.4 mm) and lower PASP (ΔPASP -14.7 ± 11.9 mmHg). Improvement in TAPSE/PASP was associated with less residual MR and better functional status after the procedure, but not with a lower risk of death or heart failure hospitalization during follow-up. In contrast, preserved RV-PA coupling at one month after M-TEER, defined as TAPSE/PASP >0.33 mm/mmHg, identified a subgroup at lower risk of the primary endpoint (hazard ratio 0.46 [95% confidence interval 0.26-0.81], p = 0.008).
CONCLUSION: M-TEER is associated with improvement in RV-PA coupling in patients with primary or atrial MR. Persistent RV-PA uncoupling identifies a high-risk group for adverse events after the procedure. Future studies in dedicated aetiology-specific cohorts are required to establish the role of serial RV-PA coupling assessment in post-procedural risk stratification after M-TEER.