Prognostic impacts of post-procedural right ventricular fractional area change in patients after mitral valve transcatheter edge-to-edge repair

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Abstract Background Right ventricular (RV) fractional area change (FAC) is an established as an important prognostic parameter in various cardiovascular diseases, including mitral regurgitation (MR). However, its prognostic significance after mitral valve transcatheter edge-to-edge repair (M-TEER) remains unclear. This study aimed to assess the impact of post-procedural RVFAC on clinical outcomes in patients undergoing M-TEER. Methods We retrospectively analyzed 246 patients (mean age 80±10 years) who underwent M-TEER and echocardiographic follow-up at one day post-procedure. Cardiovascular events (CVEs) were defined as cardiac-death and hospitalization for heart failure (HF). Results During a median follow-up period of 988 days (range, 581 to 1380 days), 17 cardiac-deaths and 60 HF admissions occurred. Pre- and post-procedural RVFAC, as well as increased post-procedural mitral gradient, were independent predictors of CVEs in the multivariable analysis adjusted for age, sex, body mass index, history of HF admission, catecholamine infusion, pre- and post-procedural tricuspid annular plane systolic excursion, and more than moderate residual MR (Hazard ratio (HR) 1.06 [1.00 to 1.12], P=0.02; HR 0.87 [0.83 to 0.91], P<0.001; HR 2.40 [1.30 to 4.41], P=0.004, respectively). A post-procedural RVFAC of 35% was the optimal cutoff value for predicting CVEs with a sensitivity of 62% and a specificity of 81%. Its C-statistic was significantly superior to that of the pre-procedural RVFAC (P<0.001). Conclusion Post-procedural RVFAC is a significant and superior predictor of adverse cardiovascular events in patients undergoing M-TEER.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.