Valvular & structural heart disease
Residual Mitral Regurgitation Interacts With Transmitral Mean Pressure Gradient to Modify the Association With Mortality Following Transcatheter Edge-to-Edge Repair
Authors' conclusion
Both rMR and TMPG were nonlinearly associated with 1-year mortality. At low levels of rMR, changes in TMPG are associated with only small changes in the risk of death. Conversely, at higher levels of rMR, even small changes in TMPG are associated with larger changes in the absolute risk of death.
Study context
- Population
- Patients with severe secondary (functional) MR undergoing mitral transcatheter edge-to-edge repair with the MitraClip systempatients with secondary MR who underwent mitral transcatheter edge-to-edge repair in 11 centers
- Participants
- 570 patients
- Exposure
- Association of intraoperatively measured residual mitral regurgitation (rMR) and transmitral mean pressure gradient (TMPG) with 1-year mortality
Methodological details11 centers, fractional polynomials
- 11 centers
- Fractional polynomials
Main finding
As reported in the abstract
Patient characteristics
Men
61%
Age
72±12 years
TMPG <5 mm Hg
78%
TMPG ≥5 mm Hg
22%
Observational data: associations, not effects.
Further findings
Association with mortality · 1 year
| Comparison | Odds ratio (95% CI) | P value | |
|---|---|---|---|
| rMR · for rMR .5; adjusted for confounders · After adjustment for confounders | 2.10 (1.88–2.35) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
| Outcome | Odds ratio (95% CI) | P value | |
|---|---|---|---|
| Association with mortality · 1 year — TMPG 4 vs TMPG=2 mm Hg · at rMR=1+ · After adjustment for confounders | 1.26 (1.19–1.32) | ||
| Association with mortality · 1 year — TMPG 6 vs TMPG=2 mm Hg · at rMR=1+ · After adjustment for confounders | 1.84 (1.58–2.10) | ||
| Association with mortality · 1 year — TMPG 8 vs TMPG=2 mm Hg · at rMR=1+ · After adjustment for confounders | 3.13 (2.31–3.98) | ||
| 0.20.5125Odds ratio (log scale) |
Postprocedural MR severity
- ≤2+
- 95%
- ≤1+
- 76%
- 3+
- 3%
- 4+
- 2%
Mortality · 1 year
- 1-year mortality
- 20%
Original publication
Residual Mitral Regurgitation Interacts With Transmitral Mean Pressure Gradient to Modify the Association With Mortality Following Transcatheter Edge-to-Edge Repair. Circ Cardiovasc Interv. Published 28 January 2025. doi:10.
Summarised from the published abstract; every number is checked against it