Valvular & structural heart diseaseCohort study
Transmitral Gradients and Mortality Following Transseptal Transcatheter Mitral Valve in Valve
- Registry-based cohort study
- STS/ACC TVT Registry
- adjusted Cox proportional hazards models
Authors' conclusion
Following MVIV, TMG <4 mm Hg was associated with lower CO and cardiac index and increased mortality at 3 years compared with TMG 4 to 7 mm Hg and >7 mm Hg.
Study context
- Population
- All comers undergoing transcatheter mitral valve in valve (MVIV), August 2015 to March 2024896 mortality events
- Participants
- 5,401 participants
- Exposure
- Low vs intermediate vs high discharge transmitral gradient after MVIV
- Outcome
- All-cause mortality
- Follow-up
- 3 years
Main finding
As reported in the abstract
All-cause mortality by discharge TMG
Adjusted hazard ratio (95% CI)P value
Low TMG vs Intermediate TMG
1.52(1.22–1.89)
P = 0.0002Low TMG vs High TMG
1.35(1.07–1.71)
P = 0.01Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Invasive cardiac output — Low TMG vs Intermediate TMG · lower with low TMG | P = 0.0003 |
| Invasive cardiac output — Low TMG vs High TMG · lower with low TMG | P < 0.0001 |
| Cardiac index — Low TMG vs Intermediate TMG · lower with low TMG | P = 0.04 |
| Cardiac index — Low TMG vs High TMG · lower with low TMG | P = 0.0002 |
Discharge vs 30-day gradient groups
- Discharge and 30-day gradient groups varied and should not be interchangeable
Original publication
Transmitral Gradients and Mortality Following Transseptal Transcatheter Mitral Valve in Valve. JACC Cardiovasc Interv. Published 13 April 2026. doi:10.1016/j.jcin.2025.12.026
Summarised from the published abstract; every number is checked against it