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1000 Titel
  • Concomitant tricuspid regurgitation severity and its secondary reduction determine long-term prognosis after transcatheter mitral valve edge-to-edge repair
1000 Autor/in
  1. Geyer, Martin |
  2. Keller, Karsten |
  3. Bachmann, Kevin |
  4. Born, Sonja |
  5. Tamm, Alexander R. |
  6. Ruf, Tobias Friedrich |
  7. Kreidel, Felix |
  8. Hahad, Omar |
  9. Petrescu, Aniela |
  10. Hell, Michaela |
  11. Beiras-Fernandez, Andres |
  12. Kornberger, Angela |
  13. Schulz, Eberhard |
  14. Münzel, Thomas |
  15. von Bardeleben, Ralph Stephan |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-01-12
1000 Erschienen in
1000 Quellenangabe
  • 110(5):676-688
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00392-020-01798-4 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099767/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!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.!##!Methods!#!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.!##!Results!#!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%, p = 0.030; HR for death 1.68 (95% CI 1.12-2.54), p = 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), p = 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%, p = 0.025; HR for death at 1-year follow-up 3.31 (95% CI 1.15-9.58), p = 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%, p = 0.021).!##!Conclusion!#!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.
1000 Sacherschließung
lokal Female [MeSH]
lokal Aged, 80 and over [MeSH]
lokal Aged [MeSH]
lokal Mortality [MeSH]
lokal Mitral Valve Insufficiency/surgery [MeSH]
lokal Tricuspid regurgitation
lokal Humans [MeSH]
lokal Mitral valve repair
lokal Severity of Illness Index [MeSH]
lokal Natriuretic Peptide, Brain/metabolism [MeSH]
lokal Cardiac Catheterization/methods [MeSH]
lokal Retrospective Studies [MeSH]
lokal MitraClip
lokal Multidisciplinary heart team
lokal Time Factors [MeSH]
lokal Tricuspid Valve Insufficiency/physiopathology [MeSH]
lokal Survival
lokal Male [MeSH]
lokal Original Paper
lokal Prognosis [MeSH]
lokal Mitral regurgitation
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-9935-8293|https://frl.publisso.de/adhoc/uri/S2VsbGVyLCBLYXJzdGVu|https://frl.publisso.de/adhoc/uri/QmFjaG1hbm4sIEtldmlu|https://frl.publisso.de/adhoc/uri/Qm9ybiwgU29uamE=|https://frl.publisso.de/adhoc/uri/VGFtbSwgQWxleGFuZGVyIFIu|https://frl.publisso.de/adhoc/uri/UnVmLCBUb2JpYXMgRnJpZWRyaWNo|https://frl.publisso.de/adhoc/uri/S3JlaWRlbCwgRmVsaXg=|https://frl.publisso.de/adhoc/uri/SGFoYWQsIE9tYXI=|https://frl.publisso.de/adhoc/uri/UGV0cmVzY3UsIEFuaWVsYQ==|https://frl.publisso.de/adhoc/uri/SGVsbCwgTWljaGFlbGE=|https://frl.publisso.de/adhoc/uri/QmVpcmFzLUZlcm5hbmRleiwgQW5kcmVz|https://frl.publisso.de/adhoc/uri/S29ybmJlcmdlciwgQW5nZWxh|https://frl.publisso.de/adhoc/uri/U2NodWx6LCBFYmVyaGFyZA==|https://frl.publisso.de/adhoc/uri/TcO8bnplbCwgVGhvbWFz|https://orcid.org/0000-0002-1356-0037
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