Valvular & structural heart disease
Understanding the Effects of Mitral Transcatheter Edge-to-Edge Repair on Left Ventricular Function Using Pressure-Volume Loops
Authors' conclusion
After M-TEER, there is no significant change in invasive indices of LV contractility. Tau is significantly prolonged after M-TEER, whereas LV chamber stiffness constant is abnormally increased before M-TEER without a significant change afterward. Patients with LA "V" wave pressure ≥20 mm Hg after M-TEER have worse LV diastolic function and higher LA operating chamber stiffness.
Study context
- Population
- Patients with primary mitral regurgitation (MR) undergoing mitral transcatheter edge-to-edge repair (M-TEER), with a control group of heart transplant recipients with normal function
- Participants
- 22 vs 17
- Comparison
- Primary MR patients vs control group; before vs after M-TEER
- Primary MRn = 22
- Control groupn = 17
- Outcome
- LV volumes, diastolic pressures, tau, and LV chamber stiffness constant
Main finding
As reported in the abstract
- Increased in primary MR patients compared to the control group
- all P ≤ 0.01
Further findings
Left ventricular (LV) and left atrial (LA) volumes and pressures and MR regurgitant volume · After M-TEER
- Decreased after M-TEER
- all P < 0.05
LV preload recruitable stroke work, end systolic pressure/volume, pressure volume area, chamber stiffness constant · After M-TEER
- LV preload recruitable stroke work
- 50.7 ± 14 vs 47 ± 17 mm Hg
- End systolic pressure/volume
- 1.67 ± 0.69 vs 1.66 ± 0.62 mm Hg/mL
- Pressure volume area
- 11,493 ± 3,428 vs 11,898 ± 5,256 mm Hg. mL
- Chamber stiffness constant
- 0.05 ± 0.07 vs 0.03 ± 0.02
- Without significant change, all P > 0.20
LA operating chamber stiffness, tau, and LV chamber stiffness constant by LA V wave pressure (subgroup) · Post-M-TEER
- Significantly higher in patients with LA V wave pressure ≥20 mm Hg vs <20 mm Hg
- P < 0.05
Original publication
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