Valvular & structural heart diseaseCohort study
Combined Impact of Residual Mitral Regurgitation and Gradient After Mitral Valve Transcatheter Edge-to-Edge Repair
- Pooled patient-level cohort study
- pooled patient-level cohort of EXPAND and EXPAND G4
- echocardiographic core laboratory assessment
Authors' conclusion
Reduction of MR to mild or less after M-TEER with the latest-generation MitraClip systems was associated with clinical benefit regardless of MVG.
Study context
- Population
- Patients undergoing mitral transcatheter edge-to-edge repair (M-TEER) with third- or fourth-generation MitraClip systems (EXPAND and EXPAND G4 studies)evaluable 30-day echocardiograms
- Participants
- 1,723 patients
- Exposure
- Combinations of 30-day residual mitral regurgitation (MR) grade and mean mitral valve gradient (MVG) after M-TEER
- Outcome
- All-cause mortality and HF hospitalization
- Follow-up
- 1 year
Main finding
As reported in the abstract
- Lower for subjects achieving MR ≤1+ at 30 days, regardless of MVG
Observational data: associations, not effects.
Further findings
Distribution of 30-day MR/MVG groups
| Outcome | MR ≤1+/MVG <5 mm Hg | MR ≤1+/MVG ≥5 mm Hg | MR ≥2+/MVG <5 mm Hg | MR ≥2+/MVG ≥5 mm Hg |
|---|---|---|---|---|
| Mean MVG, 30 days to 1 year (MVG ≥5 mm Hg groups) | ||||
| 30 days | Not reported in the abstract | 6.7 ± 4.0 | Not reported in the abstract | 6.5 ± 1.5 |
| 1 year | Not reported in the abstract | 5.5 ± 2.5 | Not reported in the abstract | 5.5 ± 1.7 |
MR ≤1+ sustained through 1 year (among those with 30-day MR ≤1+)
- MR ≤1+ sustained
- 93%
Original publication
Combined Impact of Residual Mitral Regurgitation and Gradient After Mitral Valve Transcatheter Edge-to-Edge Repair. JACC Cardiovasc Interv. Published 23 October 2024. doi:10.1016/j.jcin.2024.08.004
Summarised from the published abstract; every number is checked against it