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Valvular & structural heart disease

Left ventricular reverse remodelling after mitral transcatheter edge-to-edge repair: results from the EXPANDed studies

ESC Heart FailPublished

  • cohort
  • independent echocardiographic core laboratories
+1 more
  • independent echocardiographic core laboratories
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Authors' conclusion

Regardless of aetiology, most patients experienced early LVRR after M-TEER with significant MR reduction and symptom relief. In SMR patients, early LVRR was associated with lower rates of HF hospitalization and death.

Study context

Population
Patients with primary (PMR) and secondary mitral regurgitation (SMR) treated with mitral transcatheter edge-to-edge repair (M-TEER), from the EXPAND and EXPAND G4 studiespatients treated with M-TEER in the EXPANDed cohort · SMR 527 · PMR 536
Participants
2,205 patients
Exposure
Early left ventricular reverse remodelling (LVRR) vs no early LVRR after M-TEER

Main finding

As reported in the abstract

Early LVRR incidence, SMR patients · 30 days

SMR patients with early LVRR (of 527 SMR patients)

338 patients (64.1%)

Observational data: associations, not effects.

Further findings

Death or HF hospitalizations, SMR patients · 1 year · lower with early LVRR

P = 0.009

Composite all-cause mortality or HF hospitalization, PMR patients · 1 year

P = 0.47

All-cause mortality, PMR patients with dilated ventricles · lower with early LVRR

P = 0.028

Death or heart failure (HF) hospitalizations, SMR patients — early LVRR 24.7% vs no early LVRR 35.9%, P =
.009
Death or HF hospitalizations, SMR patients — early LVRR 24.7% vs no early LVRR 35.9%, P =
.009
Death or HF hospitalizations, SMR patients — early LVRR 24.7% vs no early LVRR 35.9%, P =
.009
Composite all-cause mortality or HF hospitalization, PMR patients — NYHA ≤II
≥83%
Composite all-cause mortality or HF hospitalization, PMR patients — KCCQ-OS improvement
∼19-point

Independent associations with early LVRR, SMR patients

hypertension
OR = 1.96, P = .004
absence of prior cardiac surgeries
OR = 0.51, P = .002
smaller left ventricular (LV) end-systolic volume
OR = 0.81, P = .002

Early LVRR incidence, PMR patients · 30 days

PMR patients with early LVRR (of 536 PMR patients)
391 (73.0%)

Original publication

Left ventricular reverse remodelling after mitral transcatheter edge-to-edge repair: results from the EXPANDed studies. ESC Heart Fail. Published 16 March 2026. doi:10.1093/eschf/xvag081
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Summarised from the published abstract; every number is checked against it