Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling
Abstract Background Atrial secondary mitral valve regurgitation (ASMR) is a distinct anatomical subset of secondary mitral regurgitation (SMR). Evidence of the effect of transcatheter edge‐to‐edge repair (TEER) on left atrial (LA) anatomy and function, especially reverse remodelling (LARR), is still...
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Wiley
2025-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15252 |
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| author | Aniela Petrescu Martin Geyer Julian Andres Gelves Meza Omar Hahad Tobias Ruf Valeria Maria deLuca Lukas Hobohm Theresa Gößler Felix Kreidel Philipp Lurz Ralph Stephan vonBardeleben |
| author_facet | Aniela Petrescu Martin Geyer Julian Andres Gelves Meza Omar Hahad Tobias Ruf Valeria Maria deLuca Lukas Hobohm Theresa Gößler Felix Kreidel Philipp Lurz Ralph Stephan vonBardeleben |
| author_sort | Aniela Petrescu |
| collection | DOAJ |
| description | Abstract Background Atrial secondary mitral valve regurgitation (ASMR) is a distinct anatomical subset of secondary mitral regurgitation (SMR). Evidence of the effect of transcatheter edge‐to‐edge repair (TEER) on left atrial (LA) anatomy and function, especially reverse remodelling (LARR), is still sparse. Methods and results We retrospectively evaluated all consecutive patients treated with TEER for mitral regurgitation (MR) in our centre between January 2013 and October 2023. Of the 597 patients with SMR, 103 patients (17.3%) met the inclusion criteria for ASMR. All patients in the ASMR group (mean age 79.4 ± 6.8 years, 71% female) were symptomatic (89% NYHA ≥ III) and had a mean logistic EuroScore of 22.5 ± 12.4%. TEER was successfully performed in all patients, and invasive LA mean pressures decreased intraprocedurally from 17.8 ± 5.7 to 13.1 ± 4.8 mmHg (P < 0.001). At hospital discharge, 94% of patients had mild residual or non/trace MR. At 1YFUP, the prevalence of residual moderate MR was 7% and 1% had severe MR. A significant reduction in LA volume compared with baseline, both at end‐systole (151.4 ± 64 vs. 113 ± 64 mL, P < 0.001) and at end‐diastole (119.8 ± 56 vs. 91.2 ± 56.9 mL, P < 0.001) could be observed. Seventy per cent of patients had a sustained decrease in NYHA class ≤ II. LARR, defined as LAESV decrease ≥15% at 1YFUP, was documented in 59% of patients. These patients were more likely to have lower post‐interventional mitral valve mean pressure gradients (2.2 ± 0.8 mmHg vs. 2.8 ± 1.1 mmHg, P = 0.02) and lower BNP at discharge and at 1 month follow‐up [319 (197.8 to 526) vs. 560 (279.3 to 929), P = 0.07, and 287.5 (191.3 to 386.3) vs. 506.5 (223.3 to 935.5), P = 0.06, respectively]. A multivariate logistic regression analysis identified pre‐procedural MPG (P = 0.06, OR 0.92, CI 95% 0.85–1.00) and BNP at discharge (P = 0.11, OR 0.99, CI 95% 0.99–1.00) as independent predictors for the occurrence of LARR at 1 year. Conclusions 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. |
| format | Article |
| id | doaj-art-a025fb3af3b044e4904ccce60711a8bf |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-06-01 |
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| series | ESC Heart Failure |
| spelling | doaj-art-a025fb3af3b044e4904ccce60711a8bf2025-08-20T03:53:16ZengWileyESC Heart Failure2055-58222025-06-011232267227710.1002/ehf2.15252Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodellingAniela Petrescu0Martin Geyer1Julian Andres Gelves Meza2Omar Hahad3Tobias Ruf4Valeria Maria deLuca5Lukas Hobohm6Theresa Gößler7Felix Kreidel8Philipp Lurz9Ralph Stephan vonBardeleben10Department of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology Universitätsklinikum Schleswig‐Holstein, Campus Kiel Kiel GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyDepartment of Cardiology, Cardiology I University Medical Center Mainz of the Johannes Gutenberg‐University Mainz Mainz GermanyAbstract Background Atrial secondary mitral valve regurgitation (ASMR) is a distinct anatomical subset of secondary mitral regurgitation (SMR). Evidence of the effect of transcatheter edge‐to‐edge repair (TEER) on left atrial (LA) anatomy and function, especially reverse remodelling (LARR), is still sparse. Methods and results We retrospectively evaluated all consecutive patients treated with TEER for mitral regurgitation (MR) in our centre between January 2013 and October 2023. Of the 597 patients with SMR, 103 patients (17.3%) met the inclusion criteria for ASMR. All patients in the ASMR group (mean age 79.4 ± 6.8 years, 71% female) were symptomatic (89% NYHA ≥ III) and had a mean logistic EuroScore of 22.5 ± 12.4%. TEER was successfully performed in all patients, and invasive LA mean pressures decreased intraprocedurally from 17.8 ± 5.7 to 13.1 ± 4.8 mmHg (P < 0.001). At hospital discharge, 94% of patients had mild residual or non/trace MR. At 1YFUP, the prevalence of residual moderate MR was 7% and 1% had severe MR. A significant reduction in LA volume compared with baseline, both at end‐systole (151.4 ± 64 vs. 113 ± 64 mL, P < 0.001) and at end‐diastole (119.8 ± 56 vs. 91.2 ± 56.9 mL, P < 0.001) could be observed. Seventy per cent of patients had a sustained decrease in NYHA class ≤ II. LARR, defined as LAESV decrease ≥15% at 1YFUP, was documented in 59% of patients. These patients were more likely to have lower post‐interventional mitral valve mean pressure gradients (2.2 ± 0.8 mmHg vs. 2.8 ± 1.1 mmHg, P = 0.02) and lower BNP at discharge and at 1 month follow‐up [319 (197.8 to 526) vs. 560 (279.3 to 929), P = 0.07, and 287.5 (191.3 to 386.3) vs. 506.5 (223.3 to 935.5), P = 0.06, respectively]. A multivariate logistic regression analysis identified pre‐procedural MPG (P = 0.06, OR 0.92, CI 95% 0.85–1.00) and BNP at discharge (P = 0.11, OR 0.99, CI 95% 0.99–1.00) as independent predictors for the occurrence of LARR at 1 year. Conclusions 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.https://doi.org/10.1002/ehf2.15252Atrial secondary mitral regurgitationEchocardiographyPercutaneous edge‐to‐edge repair |
| spellingShingle | Aniela Petrescu Martin Geyer Julian Andres Gelves Meza Omar Hahad Tobias Ruf Valeria Maria deLuca Lukas Hobohm Theresa Gößler Felix Kreidel Philipp Lurz Ralph Stephan vonBardeleben Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling ESC Heart Failure Atrial secondary mitral regurgitation Echocardiography Percutaneous edge‐to‐edge repair |
| title | Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling |
| title_full | Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling |
| title_fullStr | Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling |
| title_full_unstemmed | Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling |
| title_short | Transcatheter edge‐to‐edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling |
| title_sort | transcatheter edge to edge repair of atrial secondary mitral regurgitation positively influences atrial remodelling |
| topic | Atrial secondary mitral regurgitation Echocardiography Percutaneous edge‐to‐edge repair |
| url | https://doi.org/10.1002/ehf2.15252 |
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