Universität zu Köln

von Stein, Philipp ORCID: 0000-0003-4548-3897, Weimann, Jessica, Pfister, Roman ORCID: 0000-0002-4358-5008, Ludwig, Sebastian, Koell, Benedikt, Donal, Erwan, Patel, Dhairya, Stolz, Lukas, Tanaka, Tetsu, Scotti, Andrea, Trenkwalder, Teresa, Rudolph, Felix, Samim, Daryoush, Giannini, Cristina, Dreyfus, Julien, Paradis, Jean-Michel, Adamo, Marianna, Karam, Nicole, Bohbot, Yohann, Bernard, Anne, Melica, Bruno, Quagliana, Angelo, Badie, Yoan Lavie, Kessler, Mirjam, Chehab, Omar, Redwood, Simon, Lubos, Edith, Sondergaard, Lars, Metra, Marco, Primerano, Chiara, Praz, Fabien, Gerçek, Muhammed, Xhepa, Erion, Nickenig, Georg, Latib, Azeem, Schofer, Niklas, Makkar, Raj, Granada, Juan F., Modine, Thomas, Hausleiter, Jörg, Coisne, Augustin, Kalbacher, Daniel and Iliadis, Christos ORCID: 0000-0001-7655-8500 (2025). Prognostic Value of NT-ProBNP in Patients with Primary Mitral Regurgitation Undergoing Transcatheter Edge-To-Edge Repair. European Journal of Heart Failure, 27 (12). pp. 2921-2934. Wiley. ISSN 1388-9842

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Abstract

Aims: The prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) for primary mitral regurgitation (PMR) is unclear. This study assessed the association between NT-proBNP and outcomes and explored its additive value to the Mitral Regurgitation International Database (MIDA) score. Methods and results: PRIME-MR, a retrospective, international, multicentre registry, includes 3083 consecutive PMR patients treated with M-TEER. This analysis focused on 1382 patients (median age 81 years, 47% female, 82% New York Heart Association [NYHA] functional class III/IV, median EuroSCORE II 4.1%) with available NT-proBNP levels and follow-up. The primary endpoint was death or heart failure hospitalization within 3 years. Median NT-proBNP level was 1991 pg/ml (T1: 578, T3: 6285), and 384 patients reached the primary endpoint (Kaplan–Meier estimate: 48.5%). Log-transformed NT-proBNP levels independently predicted the primary endpoint (adjusted hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.07–1.28; p < 0.001) after adjusting for NYHA class, haemoglobin, creatinine, and atrial fibrillation. In 1041 patients with a modified MIDA score (median 9), the score was initially associated with the primary endpoint (HR 1.10, 95% CI 1.04–1.17; p = 0.002), but lost significance when adjusting for NT-proBNP levels, which remained independently predictive (adjusted HR 1.20, 95% CI 1.07–1.34; p = 0.002). Conclusions: NT-proBNP, but not the MIDA score, was independently associated with death or heart failure hospitalizations within 3 years in M-TEER-treated PMR patients. Incorporating NT-proBNP levels into clinical assessment may improve risk stratification and potentially supports earlier intervention at lower NT-proBNP levels to optimize outcomes.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code von Stein, Philipp UNSPECIFIED https://orcid.org/0000-0003-4548-3897 UNSPECIFIED Weimann, Jessica UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED https://orcid.org/0000-0002-4358-5008 UNSPECIFIED Ludwig, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Koell, Benedikt UNSPECIFIED UNSPECIFIED UNSPECIFIED Donal, Erwan UNSPECIFIED UNSPECIFIED UNSPECIFIED Patel, Dhairya UNSPECIFIED UNSPECIFIED UNSPECIFIED Stolz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Tanaka, Tetsu UNSPECIFIED UNSPECIFIED UNSPECIFIED Scotti, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Trenkwalder, Teresa UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Samim, Daryoush UNSPECIFIED UNSPECIFIED UNSPECIFIED Giannini, Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Dreyfus, Julien UNSPECIFIED UNSPECIFIED UNSPECIFIED Paradis, Jean-Michel UNSPECIFIED UNSPECIFIED UNSPECIFIED Adamo, Marianna UNSPECIFIED UNSPECIFIED UNSPECIFIED Karam, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED Bohbot, Yohann UNSPECIFIED UNSPECIFIED UNSPECIFIED Bernard, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Melica, Bruno UNSPECIFIED UNSPECIFIED UNSPECIFIED Quagliana, Angelo UNSPECIFIED UNSPECIFIED UNSPECIFIED Badie, Yoan Lavie UNSPECIFIED UNSPECIFIED UNSPECIFIED Kessler, Mirjam UNSPECIFIED UNSPECIFIED UNSPECIFIED Chehab, Omar UNSPECIFIED UNSPECIFIED UNSPECIFIED Redwood, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Lubos, Edith UNSPECIFIED UNSPECIFIED UNSPECIFIED Sondergaard, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Metra, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Primerano, Chiara UNSPECIFIED UNSPECIFIED UNSPECIFIED Praz, Fabien UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerçek, Muhammed UNSPECIFIED UNSPECIFIED UNSPECIFIED Xhepa, Erion UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Latib, Azeem UNSPECIFIED UNSPECIFIED UNSPECIFIED Schofer, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Makkar, Raj UNSPECIFIED UNSPECIFIED UNSPECIFIED Granada, Juan F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Modine, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hausleiter, Jörg UNSPECIFIED UNSPECIFIED UNSPECIFIED Coisne, Augustin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalbacher, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED https://orcid.org/0000-0001-7655-8500 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-803483
Identification Number:	10.1002/ejhf.3725
Journal or Publication Title:	European Journal of Heart Failure
Volume:	27
Number:	12
Page Range:	pp. 2921-2934
Number of Pages:	14
Date:	1 December 2025
Publisher:	Wiley
ISSN:	1388-9842
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Primary mitral regurgitation ; Mitral valve transcatheter edge-to-edge repair ; NT-proBNP ; PRIME-MR English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80348