Valvular & structural heart disease
Association of pulmonary hypertension with the outcome in patients undergoing edge-to-edge mitral valve repair
Authors' conclusion
The new PH definition discriminates PH groups and mortality better than the old definition. The lower threshold of mPAP of 20mmHg improved prognostication in this cohort of patients.
Study context
- Population
- Consecutive patients treated with mitral transcatheter edge-to-edge repair (M-TEER), December 2009 to February 2015
- Participants
- 449 patients
- Exposure
- Any pulmonary hypertension (PH) vs no PH
- Outcome
- Death after M-TEER
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
PH vs No PHHazard ratio (95% CI)P value
2015 definition
1.61(1.25–2.07)
P < 0.0012022 definition
2.09(1.54–2.83)
P < 0.001Observational data: associations, not effects.
Further findings
Survival by PH subgroup (2022 definition)
- Each PH subgroup showed lower survival after M-TEER vs no PH
Correlation of echocardiographic systolic PAP with invasive pressures
- Correlation with invasive mean pulmonary artery pressure (mPAP)
- r=0.29, p<0.001
- Correlation with invasive systolic pulmonary arterial pressure
- r=0.34,p<0.001
Invasive haemodynamic predictors of all-cause mortality (Cox regression)
- Higher invasive diastolic, systolic and mean pulmonary pressures associated with higher all-cause mortality
- P < 0.001
- Higher right atrial pressure, lower pulmonary arterial compliance, higher pulmonary vascular resistance (PVR) and higher wedge pressure predicted all-cause mortality
Original publication
Association of pulmonary hypertension with the outcome in patients undergoing edge-to-edge mitral valve repair. Heart. Published 22 February 2024. doi:10.
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