Universität zu Köln

Kavsur, Refik, Iliadis, Christos, Spieker, Maximilian, Brachtendorf, Birthe M., Tiyerili, Vedat, Metze, Clemens, Horn, Patrick, Baldus, Stephan, Kelm, Malte, Nickenig, Georg, Pfister, Roman, Westenfeld, Ralf and Becher, Marc Ulrich (2021). Predictors and prognostic relevance of tricuspid alterations in patients undergoing transcatheter edge-to-edge mitral valve repair. EuroIntervention, 17 (10). S. 827 - 845. TOULOUSE CEDEX 6: EUROPA EDITION. ISSN 1969-6213

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Abstract

Background: Mitral valve repair may lead to alterations of tricuspid regurgitation (TR). Aims: We aimed to investigate alterations, predictors and prognostic relevance of TR evolution in a largescale multicentre population of patients undergoing transcatheter mitral valve repair (TMVR) via the MitraClip. Methods: In total, we included 531 TMVR patients with at least one available follow-up echocardiography. TR improvement was defined as a TR >II at baseline, which showed a decline of at least one TR categorisation. Results: Distribution of preprocedural TR severity was TR 0/I 41% (220/531), TR II 39% (209/531) and TR >III 19% (102/531), respectively. Follow-up echocardiography was at 308 +/- 187 days. TR severity improved to TR 0/I 49% (259/531), TR II 35% (183/531) and TR III 17% (89/531), p=0.003. Out of 311 patients with TR >II at baseline, 41% (127/311) showed TR improvement. Atrial fibrillation (AF), residual mitral regurgitation >II (rMR) and tricuspid annular diameter (TAD) remained variables which prevented TR improvement (odds ratio 0.49 [0.29-0.84], 0.47 [0.27-0.81] and 0.97 [0.93-0.997], respectively). TR improvement was associated with better event-free survival regarding post-procedural heart failure hospitalisation (HHF) (hazard ratio 0.6 [0.38-0.94]). The main changes of TR severity occurred within 3 months post TMVR (p=0.006), while there were only minor TR changes between 3 and 12 months of follow-up (p=0.813). Conclusions: TR improvement was frequent after TMVR. Predictors preventing TR improvement were AF, post-procedural rMR, and TAD. Furthermore, TR improvement was an early phenomenon occurring primarily within the first three months post TMVR and served as a suitable marker of reduced HHF.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kavsur, Refik UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Spieker, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Brachtendorf, Birthe M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tiyerili, Vedat UNSPECIFIED UNSPECIFIED UNSPECIFIED Metze, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kelm, Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Westenfeld, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Becher, Marc Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-581199
DOI:	10.4244/EIJ-D-20-01094
Journal or Publication Title:	EuroIntervention
Volume:	17
Number:	10
Page Range:	S. 827 - 845
Date:	2021
Publisher:	EUROPA EDITION
Place of Publication:	TOULOUSE CEDEX 6
ISSN:	1969-6213
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ECHOCARDIOGRAPHIC-ASSESSMENT; EUROPEAN ASSOCIATION; REGURGITATION; OUTCOMES; IMPACT; SYSTEM; HEART Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58119