Concomitant tricuspid regurgitation severity and its secondary reduction determine long-term prognosis after transcatheter mitral valve edge-to-edge repair

Publication type:
Journal article
Metadata:
Abstract
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Concomitant tricuspid regurgitation (TR) is a common finding in mitral regurgitation (MR). Transcatheter repair (TMVR) is a favorable treatment option in patients at elevated surgical risk. To date, evidence on long-term prognosis and the prognostic impact of TR after TMVR is limited.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Long-term survival data of patients undergoing isolated edge-to-edge repair from June 2010 to March 2018 (combinations with other forms of TMVR or tricuspid valve therapy excluded) were analyzed in a retrospective monocentric study. TR severity was categorized and the impact of TR on survival was analysed.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Overall, 606 patients [46.5% female, 56.4% functional MR (FMR)] were enrolled in this study. TR at baseline was categorized severe/medium/mild/no or trace in 23.2/34.3/36.3/6.3% of the cases. At 30-day follow-up, improvement of at least one TR-grade was documented in 34.9%. Severe TR at baseline was identified as predictor of 1-year survival [65.2% vs. 77.0%, <jats:italic>p</jats:italic> = 0.030; HR for death 1.68 (95% CI 1.12–2.54), <jats:italic>p</jats:italic> = 0.013] and in FMR-patients also regarding long-term prognosis [adjusted HR for long-term mortality 1.57 (95% CI 1.00–2.45), <jats:italic>p</jats:italic> = 0.049]. Missing post-interventional reduction of TR severity was predictive for poor prognosis, especially in the FMR-subgroup [1-year survival: 92.9% vs. 78.3%, <jats:italic>p</jats:italic> = 0.025; HR for death at 1-year follow-up 3.31 (95% CI 1.15–9.58), <jats:italic>p</jats:italic> = 0.027]. While BNP levels decreased in both subgroups, TR reduction was associated with improved symptomatic benefit (NYHA-class-reduction 78.6 vs. 65.9%, <jats:italic>p</jats:italic> = 0.021).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In this large study, both, severe TR at baseline as well as missing secondary reduction were predictive for impaired long-term prognosis, especially in patients with FMR etiology. TR reduction was associated with increased symptomatic benefit.</jats:p> </jats:sec><jats:sec> <jats:title>Graphic abstract</jats:title> </jats:sec>
Autoren
  • Martin Geyer
  • Karsten Keller
  • Kevin Bachmann
  • Sonja Born
  • Alexander R Tamm
  • Tobias Friedrich Ruf
  • Felix Kreidel
  • Omar Hahad
  • Aniela Petrescu
  • Michaela Hell
  • Andres Beiras-Fernandez
  • Angela Kornberger
  • Eberhard Schulz
  • Thomas Münzel
  • Ralph Stephan von Bardeleben
DOI
10.1007/s00392-020-01798-4
eISSN
1861-0692
ISSN
1861-0684
Ausgabe der Veröffentlichung
5
Zeitschrift
Clinical Research in Cardiology
Sprache
en
Online publication date
2021
Paginierung
676 - 688
Datum der Veröffentlichung
2021
Status
Published
Herausgeber
Springer Science and Business Media LLC
Herausgeber URL
http://dx.doi.org/10.1007/s00392-020-01798-4
Datum der Datenerfassung
2021
Titel
Concomitant tricuspid regurgitation severity and its secondary reduction determine long-term prognosis after transcatheter mitral valve edge-to-edge repair
Ausgabe der Zeitschrift
110

Data source: Crossref

Other metadata sources:
Author's licence
CC-BY
Autoren
  • Martin Geyer
  • Karsten Keller
  • Kevin Bachmann
  • Sonja Born
  • Alexander R Tamm
  • Tobias Friedrich Ruf
  • Felix Kreidel
  • Omar Hahad
  • Aniela Petrescu
  • Michaela Hell
  • Andres Beiras-Fernandez
  • Angela Kornberger
  • Eberhard Schulz
  • Thomas Münzel
  • Ralph Stephan von Bardeleben
Hosting institution
Universitätsbibliothek Mainz
Sammlungen
  • JGU-Publikationen
Resource version
Published version
DOI
10.1007/s00392-020-01798-4
File(s) embargoed
false
Open access
true
ISSN
1861-0692
Zeitschrift
Clinical research in cardiology
Schlüsselwörter
  • 610 Medizin
  • 610 Medical sciences
Sprache
eng
Open access status
Open Access
Paginierung
676 - 688
Datum der Veröffentlichung
2021
Public URL
https://openscience.ub.uni-mainz.de/handle/20.500.12030/7251
Herausgeber
Springer
Datum der Datenerfassung
2022
Datum, an dem der Datensatz öffentlich gemacht wurde
2022
Zugang
Public
Titel
Concomitant tricuspid regurgitation severity and its secondary reduction determine long-term prognosis after transcatheter mitral valve edge-to-edge repair
Ausgabe der Zeitschrift
110

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concomitant_tricuspid_regurgi-20220627114547951.pdf

Data source: OPENSCIENCE.UB

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