Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repair
Abstract Aims Plasma volume status (PVS) is recognized as a marker of systemic congestion, but its clinical utility in patients with mitral regurgitation (MR) undergoing transcatheter edge‐to‐edge mitral valve repair (M‐TEER) has not been well established. This study aimed to evaluate the prognostic...
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2025-08-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15295 |
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| author | Ai Kagase Masanori Yamamoto Takahiro Tokuda Ryotaku Kawahata Hiroto Nishio Tetsuro Shimura Ryo Yamaguchi Mitsuru Sago Yuki Izumi Mike Saji Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bouta Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Daisuke Hachinohe Toshiaki Otsuka Shunsuke Kubo Kentaro Hayashida OCEAN‐Mitral Investigators |
| author_facet | Ai Kagase Masanori Yamamoto Takahiro Tokuda Ryotaku Kawahata Hiroto Nishio Tetsuro Shimura Ryo Yamaguchi Mitsuru Sago Yuki Izumi Mike Saji Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bouta Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Daisuke Hachinohe Toshiaki Otsuka Shunsuke Kubo Kentaro Hayashida OCEAN‐Mitral Investigators |
| author_sort | Ai Kagase |
| collection | DOAJ |
| description | Abstract Aims Plasma volume status (PVS) is recognized as a marker of systemic congestion, but its clinical utility in patients with mitral regurgitation (MR) undergoing transcatheter edge‐to‐edge mitral valve repair (M‐TEER) has not been well established. This study aimed to evaluate the prognostic significance of PVS in these patients. Methods and results Data from 3763 patients who underwent M‐TEER were analysed from a Japanese multicentre registry. Patients were classified into functional MR (FMR) and degenerative MR (DMR) according to MR aetiology, and the median PVS values for each were calculated (FMR 12.7, DMR 14.4). The median value was used as the cut‐off, stratifying the cohort into a high PVS group (n = 1882) and a low PVS group (n = 1881). All‐cause mortality, cardiovascular death, and heart failure (HF) hospitalization between these two groups were compared up to 3 years in the overall, FMR, and DMR populations. The cumulative incidence rates of all‐cause mortality, cardiovascular death, and HF hospitalization were higher in the high PVS group than in the low PVS group (47.0% vs. 22.2%, P < 0.001, 31.6% vs. 13.6%, P < 0.001, and 35.9% vs. 24.7%, P < 0.001, respectively). Similar trends in terms of all‐cause mortality, cardiovascular death, and HF hospitalization were observed in the FMR and DMR cohorts (all P < 0.05). In the multivariate Cox regression analysis, the high PVS compared with the low PVS group was independently associated with the increased risk of all‐cause death (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.01–1.03; P < 0.001), cardiovascular death (HR, 1.02; 95% CI, 1.01–1.03, P < 0.001) and HF hospitalization (HR, 1.02; 95% CI, 1.01–1.02, P < 0.001). An independent association between a high PVS and all‐cause death, cardiovascular death, and HF hospitalization was also found in FMR and DMR sub‐groups (all P < 0.05) while reducing MR severity to moderate or less after M‐TEER was associated with improved outcomes in both the high and low PVS groups. Conclusions Preoperative PVS is a strong independent prognostic marker in patients undergoing M‐TEER, correlating with increased risk of mortality and HF hospitalization. PVS may provide valuable clinical insights for patient stratification and management strategies in M‐TEER patients. |
| format | Article |
| id | doaj-art-e5fda7ab4e3b42a2ba27f6add6259146 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-e5fda7ab4e3b42a2ba27f6add62591462025-08-20T03:51:44ZengWileyESC Heart Failure2055-58222025-08-011242855286510.1002/ehf2.15295Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repairAi Kagase0Masanori Yamamoto1Takahiro Tokuda2Ryotaku Kawahata3Hiroto Nishio4Tetsuro Shimura5Ryo Yamaguchi6Mitsuru Sago7Yuki Izumi8Mike Saji9Masahiko Asami10Yusuke Enta11Masaki Nakashima12Shinichi Shirai13Masaki Izumo14Shingo Mizuno15Yusuke Watanabe16Makoto Amaki17Kazuhisa Kodama18Junichi Yamaguchi19Toru Naganuma20Hiroki Bouta21Yohei Ohno22Masahiro Yamawaki23Hiroshi Ueno24Kazuki Mizutani25Daisuke Hachinohe26Toshiaki Otsuka27Shunsuke Kubo28Kentaro Hayashida29OCEAN‐Mitral InvestigatorsDepartment of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Nagoya Heart Center Nagoya JapanDepartment of Cardiology Gifu Heart Center Gifu JapanDepartment of Cardiology Toyohashi Heart Center Toyohashi JapanDepartment of Cardiology Toyohashi Heart Center Toyohashi JapanDepartment of Cardiology Sakakibara Heart Institute Fuchu JapanDepartment of Cardiology Sakakibara Heart Institute Fuchu 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 Kitakyushu JapanDivision of Cardiology St. Marianna University School of Medicine Hospital Kawasaki JapanDepartment of Cardiology Shonan Kamakura General Hospital Kamakura JapanDepartment of Cardiology, School of Medicine Teikyo University Tokyo JapanDepartment of Cardiology National Cerebral and Cardiovascular Center Suita 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 JapanDepartment 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, Faculty of Medicine Kinki University Osaka JapanDepartment of Cardiology Sapporo Cardiovascular Clinic Sapporo JapanDepartment of Hygiene and Public Health Nippon Medical School Tokyo JapanDepartment of Cardiology Kurashiki Central Hospital Kurashiki JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanAbstract Aims Plasma volume status (PVS) is recognized as a marker of systemic congestion, but its clinical utility in patients with mitral regurgitation (MR) undergoing transcatheter edge‐to‐edge mitral valve repair (M‐TEER) has not been well established. This study aimed to evaluate the prognostic significance of PVS in these patients. Methods and results Data from 3763 patients who underwent M‐TEER were analysed from a Japanese multicentre registry. Patients were classified into functional MR (FMR) and degenerative MR (DMR) according to MR aetiology, and the median PVS values for each were calculated (FMR 12.7, DMR 14.4). The median value was used as the cut‐off, stratifying the cohort into a high PVS group (n = 1882) and a low PVS group (n = 1881). All‐cause mortality, cardiovascular death, and heart failure (HF) hospitalization between these two groups were compared up to 3 years in the overall, FMR, and DMR populations. The cumulative incidence rates of all‐cause mortality, cardiovascular death, and HF hospitalization were higher in the high PVS group than in the low PVS group (47.0% vs. 22.2%, P < 0.001, 31.6% vs. 13.6%, P < 0.001, and 35.9% vs. 24.7%, P < 0.001, respectively). Similar trends in terms of all‐cause mortality, cardiovascular death, and HF hospitalization were observed in the FMR and DMR cohorts (all P < 0.05). In the multivariate Cox regression analysis, the high PVS compared with the low PVS group was independently associated with the increased risk of all‐cause death (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.01–1.03; P < 0.001), cardiovascular death (HR, 1.02; 95% CI, 1.01–1.03, P < 0.001) and HF hospitalization (HR, 1.02; 95% CI, 1.01–1.02, P < 0.001). An independent association between a high PVS and all‐cause death, cardiovascular death, and HF hospitalization was also found in FMR and DMR sub‐groups (all P < 0.05) while reducing MR severity to moderate or less after M‐TEER was associated with improved outcomes in both the high and low PVS groups. Conclusions Preoperative PVS is a strong independent prognostic marker in patients undergoing M‐TEER, correlating with increased risk of mortality and HF hospitalization. PVS may provide valuable clinical insights for patient stratification and management strategies in M‐TEER patients.https://doi.org/10.1002/ehf2.15295Plasma volume statusTranscatheter edge‐to‐edge mitral valve repairMitral regurgitationHeart failure |
| spellingShingle | Ai Kagase Masanori Yamamoto Takahiro Tokuda Ryotaku Kawahata Hiroto Nishio Tetsuro Shimura Ryo Yamaguchi Mitsuru Sago Yuki Izumi Mike Saji Masahiko Asami Yusuke Enta Masaki Nakashima Shinichi Shirai Masaki Izumo Shingo Mizuno Yusuke Watanabe Makoto Amaki Kazuhisa Kodama Junichi Yamaguchi Toru Naganuma Hiroki Bouta Yohei Ohno Masahiro Yamawaki Hiroshi Ueno Kazuki Mizutani Daisuke Hachinohe Toshiaki Otsuka Shunsuke Kubo Kentaro Hayashida OCEAN‐Mitral Investigators Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repair ESC Heart Failure Plasma volume status Transcatheter edge‐to‐edge mitral valve repair Mitral regurgitation Heart failure |
| title | Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repair |
| title_full | Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repair |
| title_fullStr | Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repair |
| title_full_unstemmed | Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repair |
| title_short | Plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge‐to‐edge mitral valve repair |
| title_sort | plasma volume status predicting clinical outcomes in patients undergoing transcatheter edge to edge mitral valve repair |
| topic | Plasma volume status Transcatheter edge‐to‐edge mitral valve repair Mitral regurgitation Heart failure |
| url | https://doi.org/10.1002/ehf2.15295 |
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