Valvular & structural heart disease
Paradox of Disproportionate Atrial Functional Mitral Regurgitation and Survival After Transcatheter Edge-to-Edge Repair
Authors' conclusion
Paradoxically, disproportionate MR in aFMR was linked to a 1.35-fold increase in 2-year mortality post-M-TEER, emphasizing the importance of accurate preprocedural FMR characterization.
Study context
- Population
- Patients with atrial functional mitral regurgitation (MR) (normal indexed LVEDV, LVEF ≥ 50%, structurally normal mitral valves) treated with M-TEER, EuroSMR registry, 2008–2019
- Participants
- 98 patients
- Exposure
- Disproportionate vs proportionate atrial functional MR
- Outcome
- Mortality
- Follow-up
- 2 years
Methodological detailsregistry (EuroSMR)
- Registry (EuroSMR)
Main finding
As reported in the abstract
2-year mortality
- Effective regurgitant orifice area (EROA)/LVEDV ratio
- HR 1.35; P = 0.010
- Tricuspid annular plane systolic excursion (TAPSE)
- HR 0.85; P = 0.020
Observational data: associations, not effects.
Further findings
Procedural success
- Similar in both groups
Systolic pulmonary artery pressures (sPAP), NYHA ≥III, TR ≥ 3+
- Numerically higher sPAP and rates of NYHA ≥III and TR ≥ 3+ with disproportionate MR
Original publication
Paradox of Disproportionate Atrial Functional Mitral Regurgitation and Survival After Transcatheter Edge-to-Edge Repair. ESC Heart Fail. Published 11 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it