Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry
Abstract Aims Mitral transcatheter edge‐to‐edge repair (M‐TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M‐TEER candidates for effective patient selection, optimal periprocedural care and improved long‐term outcomes. The body mas...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15047 |
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| author | Ryosuke Higuchi Masaki Izumo Yuki Izumi Mike Saji Mitsuaki Isobe Yoshihiro Akashi Masanori Yamamoto Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bota Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Shunsuke Kubo Toshiaki Otsuka Kentaro Hayashida the OCEAN‐Mitral Investigators |
| author_facet | Ryosuke Higuchi Masaki Izumo Yuki Izumi Mike Saji Mitsuaki Isobe Yoshihiro Akashi Masanori Yamamoto Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bota Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Shunsuke Kubo Toshiaki Otsuka Kentaro Hayashida the OCEAN‐Mitral Investigators |
| author_sort | Ryosuke Higuchi |
| collection | DOAJ |
| description | Abstract Aims Mitral transcatheter edge‐to‐edge repair (M‐TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M‐TEER candidates for effective patient selection, optimal periprocedural care and improved long‐term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported. Methods and Results Between April 2018 and June 2021, 2149 patients undergoing M‐TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25 kg/m2) and overweight and obese (25 kg/m2 ≦ BMI) [Correction added on 17 October 2024, after first online publication: In the preceding sentence, “18.5 ☆ BMI < 25 kg/m2” and “25 kg/m2 ☆ BMI” have been corrected to “18.5 ≤ BMI < 25 kg/m2” and “25 kg/m2 ≦ BMI” in this version.] The impact of underweight on the all‐cause, cardiovascular and non‐cardiovascular mortality following M‐TEER was evaluated [follow‐up duration: 436 (363–733) days]. The participants (median BMI: 21.1 kg/m2) were categorized as underweight (n = 450, 20.9%), normal weight (n = 1409, 65.6%) and overweight and obese (n = 290, 13.5%). Compared with the other two groups, the underweight group exhibited several negative prognostic factors, including older age, frailty, no dyslipidaemia, hypoalbuminaemia, residual MR and non‐home discharge. Underweight patients had the highest rate of all‐cause, cardiovascular and non‐cardiovascular mortality, whereas those in the other two groups were similar. As per the multivariate analysis, underweight itself was associated with all‐cause mortality (hazard ratio: 1.52, 95% confidence interval: 1.17–1.97, P = 0.009) and cardiovascular mortality (hazard ratio: 1.45, 95% confidence interval: 1.04–2.01, P = 0.028). Conclusions Underweight patients had the highest mortality rate after M‐TEER. Comorbidities, residual MR, discharge disposition and underweight status were correlated with postprocedural outcome. |
| format | Article |
| id | doaj-art-7bd21ed354764feb87c91f94ba895e43 |
| institution | OA Journals |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-7bd21ed354764feb87c91f94ba895e432025-08-20T02:08:42ZengWileyESC Heart Failure2055-58222025-02-0112140841710.1002/ehf2.15047Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registryRyosuke Higuchi0Masaki Izumo1Yuki Izumi2Mike Saji3Mitsuaki Isobe4Yoshihiro Akashi5Masanori Yamamoto6Masahiko Asami7Yusuke Enta8Masaki Nakashima9Shinichi Shirai10Shingo Mizuno11Yusuke Watanabe12Makoto Amaki13Kazuhisa Kodama14Junichi Yamaguchi15Toru Naganuma16Hiroki Bota17Yohei Ohno18Masahiro Yamawaki19Hiroshi Ueno20Kazuki Mizutani21Shunsuke Kubo22Toshiaki Otsuka23Kentaro Hayashida24the OCEAN‐Mitral InvestigatorsDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDivision of Cardiology St. Marianna University School of Medicine Hospital Kawasaki JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDepartment of Cardiology Sakakibara Heart Institute Tokyo JapanDivision of Cardiology St. Marianna University School of Medicine Hospital Kawasaki JapanDepartment of Cardiology Nagoya Heart Center Nagoya JapanDivision of Cardiology Mitsui Memorial Hospital Tokyo JapanDepartment of Cardiology Sendai Kosei Hospital Sendai JapanDepartment of Cardiology Sendai Kosei Hospital Sendai JapanDivision of Cardiology Kokura Memorial Hospital Fukuoka JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology Teikyo University School of Medicine Tokyo JapanDepartment of Cardiology National Cerebral and Cardiovascular Center Osaka JapanDivision of Cardiology Saiseikai Kumamoto Hospital Cardiovascular Center Kumamoto JapanDepartment of Cardiology Tokyo Woman's Medical University Tokyo JapanDepartment of Cardiology New Tokyo Hospital Chiba JapanDepartment of Cardiology Sapporo Higashi Tokushukai Hospital Sapporo JapanDeparment of Cardiology Tokai University School of Medicine Isehara JapanDepartment of Cardiology Saiseikai Yokohama City Eastern Hospital Yokohama JapanSecond Department of Internal Medicine Toyama University Hospital Toyama JapanDivision of Cardiology, Department of Medicine Kindai University Faculty of Medicine Osaka JapanDepartment of Cardiology Kurashiki Central Hospital Okayama JapanDepartment of Hygiene and Public Health Nippon Medical School Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanAbstract Aims Mitral transcatheter edge‐to‐edge repair (M‐TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M‐TEER candidates for effective patient selection, optimal periprocedural care and improved long‐term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported. Methods and Results Between April 2018 and June 2021, 2149 patients undergoing M‐TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25 kg/m2) and overweight and obese (25 kg/m2 ≦ BMI) [Correction added on 17 October 2024, after first online publication: In the preceding sentence, “18.5 ☆ BMI < 25 kg/m2” and “25 kg/m2 ☆ BMI” have been corrected to “18.5 ≤ BMI < 25 kg/m2” and “25 kg/m2 ≦ BMI” in this version.] The impact of underweight on the all‐cause, cardiovascular and non‐cardiovascular mortality following M‐TEER was evaluated [follow‐up duration: 436 (363–733) days]. The participants (median BMI: 21.1 kg/m2) were categorized as underweight (n = 450, 20.9%), normal weight (n = 1409, 65.6%) and overweight and obese (n = 290, 13.5%). Compared with the other two groups, the underweight group exhibited several negative prognostic factors, including older age, frailty, no dyslipidaemia, hypoalbuminaemia, residual MR and non‐home discharge. Underweight patients had the highest rate of all‐cause, cardiovascular and non‐cardiovascular mortality, whereas those in the other two groups were similar. As per the multivariate analysis, underweight itself was associated with all‐cause mortality (hazard ratio: 1.52, 95% confidence interval: 1.17–1.97, P = 0.009) and cardiovascular mortality (hazard ratio: 1.45, 95% confidence interval: 1.04–2.01, P = 0.028). Conclusions Underweight patients had the highest mortality rate after M‐TEER. Comorbidities, residual MR, discharge disposition and underweight status were correlated with postprocedural outcome.https://doi.org/10.1002/ehf2.15047body mass indexobesity paradoxoutcometranscatheter edge‐to‐edge repairunderweight |
| spellingShingle | Ryosuke Higuchi Masaki Izumo Yuki Izumi Mike Saji Mitsuaki Isobe Yoshihiro Akashi Masanori Yamamoto Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bota Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Shunsuke Kubo Toshiaki Otsuka Kentaro Hayashida the OCEAN‐Mitral Investigators Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry ESC Heart Failure body mass index obesity paradox outcome transcatheter edge‐to‐edge repair underweight |
| title | Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry |
| title_full | Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry |
| title_fullStr | Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry |
| title_full_unstemmed | Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry |
| title_short | Prognostic impact of being underweight in patients undergoing mitral TEER: The OCEAN‐Mitral registry |
| title_sort | prognostic impact of being underweight in patients undergoing mitral teer the ocean mitral registry |
| topic | body mass index obesity paradox outcome transcatheter edge‐to‐edge repair underweight |
| url | https://doi.org/10.1002/ehf2.15047 |
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