Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shock
Abstract Background Transcatheter edge‐to‐edge repair (TEER) has been shown to be an effective treatment option for patients experiencing cardiogenic shock (CS) with concomitant high‐grade mitral valve regurgitation. However, haemodynamic changes following M‐TEER have not been thoroughly investigate...
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Wiley
2025-08-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15306 |
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| author | Michal Droppa Dominik Rath Philippa Jaeger Ioannis Toskas Monika Zdanyte Andreas Goldschmied Jürgen Schreieck Meinrad Gawaz Tobias Geisler |
| author_facet | Michal Droppa Dominik Rath Philippa Jaeger Ioannis Toskas Monika Zdanyte Andreas Goldschmied Jürgen Schreieck Meinrad Gawaz Tobias Geisler |
| author_sort | Michal Droppa |
| collection | DOAJ |
| description | Abstract Background Transcatheter edge‐to‐edge repair (TEER) has been shown to be an effective treatment option for patients experiencing cardiogenic shock (CS) with concomitant high‐grade mitral valve regurgitation. However, haemodynamic changes following M‐TEER have not been thoroughly investigated. Afterload mismatch, leading to the deterioration of haemodynamics subsequent to mitral regurgitation correction, could potentially occur and adversely impact prognosis. Our objective was to analyse the effect of TEER on haemodynamic and echocardiographic parameters in patients with CS. Methods and results We conducted a retrospective study of patients undergoing TEER for mitral valve regurgitation in the setting of CS. Haemodynamic and echocardiographic parameters before and after TEER were systematically analysed. A total of 25 patients underwent TEER in the context of CS. All patients were successfully treated with at least of one grade reduction in mitral regurgitation. The median left atrial mean pressure decreased from 23 mmHg (IQR 17–30) to 16 mmHg (IQR 11–20, P < 0.01), and the V‐wave decreased from 36 mmHg (IQR 27–44) to 21 mmHg (IQR 14–25, P < 0.01) following the procedure. The stroke volume index and cardiac index increased from 25 mL/m2 (IQR 18–29) to 34 mL/m2 (IQR 25–44, P < 0.01) and from 1.90 L/min/m2 (IQR 1.41–2.30) to 2.50 L/min/m2 (IQR 1.99–2.86, P < 0.01), respectively. We did not observe any worsening of the ejection fraction after the procedure. Ten patients (40%) died during their hospital stay. Conclusions Our study demonstrates that TEER leads to favourable haemodynamic changes in patients with CS. We observed a significant reduction in left atrial pressure, V‐wave, and an elevation in cardiac index. Importantly, we did not observe any deterioration in left ventricular function following the procedure. This supports the concept of haemodynamic stabilization with TEER in patients with CS and high‐grade mitral regurgitation. |
| format | Article |
| id | doaj-art-5f04bb247c4f411eb8bd865ef3baf0e2 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-5f04bb247c4f411eb8bd865ef3baf0e22025-08-20T03:51:44ZengWileyESC Heart Failure2055-58222025-08-011243173317810.1002/ehf2.15306Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shockMichal Droppa0Dominik Rath1Philippa Jaeger2Ioannis Toskas3Monika Zdanyte4Andreas Goldschmied5Jürgen Schreieck6Meinrad Gawaz7Tobias Geisler8Department of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyDepartment of Cardiology and Angiology University Hospital of Tübingen Tübingen GermanyAbstract Background Transcatheter edge‐to‐edge repair (TEER) has been shown to be an effective treatment option for patients experiencing cardiogenic shock (CS) with concomitant high‐grade mitral valve regurgitation. However, haemodynamic changes following M‐TEER have not been thoroughly investigated. Afterload mismatch, leading to the deterioration of haemodynamics subsequent to mitral regurgitation correction, could potentially occur and adversely impact prognosis. Our objective was to analyse the effect of TEER on haemodynamic and echocardiographic parameters in patients with CS. Methods and results We conducted a retrospective study of patients undergoing TEER for mitral valve regurgitation in the setting of CS. Haemodynamic and echocardiographic parameters before and after TEER were systematically analysed. A total of 25 patients underwent TEER in the context of CS. All patients were successfully treated with at least of one grade reduction in mitral regurgitation. The median left atrial mean pressure decreased from 23 mmHg (IQR 17–30) to 16 mmHg (IQR 11–20, P < 0.01), and the V‐wave decreased from 36 mmHg (IQR 27–44) to 21 mmHg (IQR 14–25, P < 0.01) following the procedure. The stroke volume index and cardiac index increased from 25 mL/m2 (IQR 18–29) to 34 mL/m2 (IQR 25–44, P < 0.01) and from 1.90 L/min/m2 (IQR 1.41–2.30) to 2.50 L/min/m2 (IQR 1.99–2.86, P < 0.01), respectively. We did not observe any worsening of the ejection fraction after the procedure. Ten patients (40%) died during their hospital stay. Conclusions Our study demonstrates that TEER leads to favourable haemodynamic changes in patients with CS. We observed a significant reduction in left atrial pressure, V‐wave, and an elevation in cardiac index. Importantly, we did not observe any deterioration in left ventricular function following the procedure. This supports the concept of haemodynamic stabilization with TEER in patients with CS and high‐grade mitral regurgitation.https://doi.org/10.1002/ehf2.15306Cardiogenic shockHeart failureMitral valve transcatheter edge‐to‐edge repair |
| spellingShingle | Michal Droppa Dominik Rath Philippa Jaeger Ioannis Toskas Monika Zdanyte Andreas Goldschmied Jürgen Schreieck Meinrad Gawaz Tobias Geisler Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shock ESC Heart Failure Cardiogenic shock Heart failure Mitral valve transcatheter edge‐to‐edge repair |
| title | Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shock |
| title_full | Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shock |
| title_fullStr | Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shock |
| title_full_unstemmed | Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shock |
| title_short | Impact of mitral valve transcatheter edge‐to‐edge repair on haemodynamic parameters in cardiogenic shock |
| title_sort | impact of mitral valve transcatheter edge to edge repair on haemodynamic parameters in cardiogenic shock |
| topic | Cardiogenic shock Heart failure Mitral valve transcatheter edge‐to‐edge repair |
| url | https://doi.org/10.1002/ehf2.15306 |
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