Valvular & structural heart disease
Transcatheter Edge-To-Edge Repair of Atrial Secondary Mitral Regurgitation Positively Influences Atrial Remodelling
Authors' conclusion
Transcatheter mitral valve repair by edge-to-edge therapy represents a safe and effective therapeutic option in symptomatic patients with atrial secondary mitral regurgitation and might have the potential to induce left atrial reverse remodelling.
Study context
- Population
- Symptomatic patients with atrial secondary mitral regurgitation (ASMR) treated with transcatheter edge-to-edge repair (TEER), January 2013 to October 2023patients meeting ASMR inclusion criteria, of the 597 patients with SMR
- Participants
- 103 patients
- Exposure
- Baseline vs follow-up after TEER; patients with vs without LARR
- Outcome
- Invasive LA mean pressure
- Follow-up
- Intraprocedural
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
- Decreased from 17.8 ± 5.7 to 13.1 ± 4.8 mmHg
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | LARR | No LARR | P value |
|---|---|---|---|
| Post-interventional mitral valve mean pressure gradientLower with LARR | 2.2 ± 0.8 mmHg | 2.8 ± 1.1 mmHg | P = 0.02 |
| BNP · discharge and 1 month follow-up | |||
| Discharge | 319 (197.8 to 526) | 560 (279.3 to 929) | |
| 1 month | 287.5 (191.3 to 386.3) | 506.5 (223.3 to 935.5) |
- BNP: discharge P = 0.07
- BNP: 1 month P = 0.06
Mild residual or non/trace mitral regurgitation (MR) · hospital discharge
- Patients
- 94%
Residual MR · 1YFUP
- Moderate MR
- 7%
- Severe MR
- 1%
Left atrial (LA) volume vs baseline
- End-systole
- 151.4 ± 64 vs. 113 ± 64 mL, P < 0.001
- End-diastole
- 119.8 ± 56 vs. 91.2 ± 56.9 mL, P < 0.001
Sustained decrease in NYHA class ≤ II
- Patients
- Seventy per cent
LARR · 1YFUP
- Patients
- 59%
Predictors of LARR at 1 year (multivariate logistic regression)
- Pre-procedural MPG
- P = 0.06, OR 0.92, CI 95% 0.85-1.00
- BNP at discharge
- P = 0.11, OR 0.99, CI 95% 0.99-1.00
Original publication
Transcatheter Edge-To-Edge Repair of Atrial Secondary Mitral Regurgitation Positively Influences Atrial Remodelling. ESC Heart Fail. Published 11 March 2025. doi:10.
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